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Karnali Pradesh

At a Glance Karnali Pradesh

Situated in the lap of Himalaya range, Karnali is one of the largest provinces of Nepal lies in the western part of Nepal. This province is the origin of human civilization and is the capital of Khas Kingdom. It covers 27,984 square kilometers (19%) of total geography of Nepal and 1.7 million (6% of National Population) inhibit here. The province is expanded from 198 m to 7767 m height from the sea level. The province is surrounded by the Tibet (China) to the North, Gandaki Pradesh to the East, Sudurpaschim to the West, and Lumbini Province to the south. Birendranagar is the capital of Karnali Pradesh. Adminstratively, Karnali Pradesh is divided into 25 municipalities, 54 rural municipalities and has 718 wards. Rara Lake, Shey Phoksundo lake, Chandannath Temple, Kuvinde Lake, Kamal Daha and ancient places as Dullu are the major attraction of this province. Water, Jungle, and Herbal (medical and aromatic) plants are the principle resources of the Karnali. About 94.9 percent of population speaking Nepali language and rest population speaks Magar, Tharu, Tamang, Kham, Gurung and Sherpa language. The per capita income of this province is 806 US dollars. Eighty five percent people are migrating another place looking for employment and 50% of their choice is India.

Key Demographics

  • Total Population 2

    1,688,412.00

    2078

  • Under 1 Population 2

    31,481.00

    2078

  • Under 5 Population 2

    168,801.00

    2078

  • Adolescent (10-19) population 2

    405,116.00

    2078

  • Women of Reproductive Age (15-49) 2

    871,650.00

    2078

  • Expected Pregnancies 1

    45,014.00

    2079/80

  • Expected Live Births 1

    35,449.00

    2079/80

  • Absent population living abroad 2

    94,320.00

    2078

  • Household with smart mobile phone (%) 2

    58.40

    2078

  • Household with television (%) 2

    17.60

    2078

  • Sex ratio 2

    95.27

    2078

  • Population aged 14 years and below 2

    558,891.00

    2078

  • Population aged 65 years and above 2

    86,495.00

    2078

  • Total fertility Rate 13

    2.00

    2016

  • Literacy Rate 2

    76.10

    2078

  • Male Literacy Rate 2

    83.30

    2078

  • Female Literacy Rate 2

    69.40

    2078

  • Households with Toilet (%) 2

    97.40

    2078

  • Households with piped water supply (%) 2

    80.10

    2078

  • Population having any kind of disability (%) 2

    3.10

    2078

  • Human Development Index 19

    0.54

    2020

  • Multi-dimensional Poverty Rate 20

    39.50

    2021
2 Census 1 Health Management Information System 13 Nepal Demographic and Health Survey 19 Nepal Human Development Report, NPC 20 Nepal Multidimensional Poverty Index Report, NPC

Age and Sex Distribution

Census 2078

Population Distribution by Caste

Census 2068

Health Service Delivery Sites

View Large

    Government Health Facilities

  • Hospital 15
  • PHCC 14
  • Health Post 333
  • Community Health Unit 101
  • Urban Health Center 25
  • PHC ORC 1014
  • EPI Clinic 1370
  • Basic Health Service Center 233
  • Birthing Center 359

    Private (Non-Government including NGO)

  • Hospital and Nursing Home 8
  • Polyclinic 29
  • Medical/Drug Shop 442

Other Service Centers

  • Microscopy Center 47
  • ART Center 6
  • HTC Center -
  • TB Treatment Center 400
  • Ayurveda Hospital/Center 18
  • Eye Hospital / Center -

Hospital Beds

  • Public 984
  • Private 150

Additonal Services

  • CEONC Site 11
  • BEONC Site 14
  • Safe Abortion Site 54
  • DR Treatment Center 2
Annual Report 2078

Health Facilities General Information

District Hospital Phcc Hp BHSC/CHU/UHC Birthing Center BEONC CEONC FCHV Number IUCD/Implant sites SBA Number Sanctioned Position Filled Position Contract Staff Building in Standard Design
RUKUM WEST 4 1 24 31 22 1 2 246 - 35 - - - -
SALYAN 1 2 45 23 46 2 1 424 - 51 - - - -
SURKHET 2 2 47 51 50 3 2 990 - 54 - - - -
DAILEKH 2 2 56 21 77 3 1 820 - 55 - - - -
JAJARKOT 1 3 31 9 28 3 1 270 - 34 - - - -
DOLPA 1 - 23 - 15 0 1 198 - 16 - - - -
JUMLA - 1 29 5 26 1 1 547 - 38 - - - -
KALIKOT 1 1 28 31 33 1 1 298 - 40 - - - -
MUGU 1 1 24 9 27 1 1 214 - 14 - - - -
HUMLA 2 - 26 6 31 0 1 237 - 27 - - - -
Total Numbers 4244 364 0 0 0
* 3 methods are Condom, Pills, Depo and 5 methods include Implant and IUDs. Annual Report 2077

Human Resources for Health

Annual Report 2076
  • Skilled Birth Attendants364
  • CEONC sites11
  • BEONC sites14
  • LARC provider (IUCD/Implant)-
  • IMNCI trained provider-
  • Population per FCHV 398
  • Population per health worker -
  • Expected pregnancy per SBA 124
  • Expected pregnancy per birthing center 125
  • Population per health facility (includes hospital, PHCC and HP) 4664
  • Population per (government) hospital 112561
  • Population per (all) hospital and Nursing Home 73409

Health Infrastructure

District HEALTH FACILITIES WITH OWN BUILDING (%) HEALTH FACILITIES WITH RECOMMENDED LAND (%) HEALTH FACILITIES WITH BIRTHING CENTER ALIGNING WITH GOVERNMENT STANDARD (%) HEALTH FACILITIES WITH STAFF QUARTER (%) HEALTH FACILITIES WITH 24 HOURS ELECTRICITY (%) HEALTH FACILITIES WITH FUNCTIONAL COMPUTER AND INTERNET (%) HEALTH FACILITIES WITH FUNCTIONAL STRETCHERS (%) HEALTH FACILITIES WITH FUNCTIONAL AMBULANCE (%) HEALTH FACILITIES ACCESS TO MOTORABLE ROAD (%)
DOLPA 61 52 29 29 45 0 74 0 -
MUGU 50 64 34 26 14 54 100 6 -
HUMLA 61 45 41 28 25 27 78 0 -
JUMLA 67 61 51 41 16 51 100 3 -
KALIKOT 32 33 14 15 2 31 33 3 -
DAILEKH 87 67 28 13 39 36 100 15 -
JAJARKOT 43 43 15 11 44 35 100 3 -
RUKUM WEST 34 31 35 10 35 47 56 3 -
SALYAN 60 48 12 14 48 42 100 15 -
SURKHET 76 68 44 39 42 58 100 11 -
Annual Report 2077

Provincial Plan, Policies, guidelines, and strategies

Endorsed Draft
Routine Data Quality Assessment
Monitoring, Evaluation and Supervision Guideline
Health Act
Endorsed Draft
Health Policy 2076

Health Budget

Annual Report 2079
  • Health Budget (Conditonal)
  • Health Budget (Unconditional)
  • Health Budget (Other Sources)
Budget
2075/76 2076/77 2077/78
Graph
Total Province Budget 28,282,828,000 34,353,425,000 33,741,353,000
Health Budget (all source) 1,493,609,000 679,546,947
Health Budget (Conditional) 847,317,000 677,533,000
Health Budget (Unconditional) 646,292,000 2,013,947
Health Budget (Other Sources)
Budget per health facilty per year (NRs) 1,493,609,000 679,546,947
Budget per person per year (NRs) 1,493,609,000 679,546,947
Budget Expenditure (%) 50 59 -
% of health budget among total budget - - -
Insurance covered district - - -
Total Insured Population - - -
Table

Health Service Readiness

Availability of Basic Health Services

Availability of Basic Health Amenities

Nepal Health Facility Survey 2021

Minimum standard to provide quality health care service

Indicators Managing Authority
Public Private and Others Provincial Average National Average
Health facilities with soap and running water or alcohol-based hand disinfectant(%) 97 98 99 98
Health Facilities practicing safe final disposal of infectious waste (%) 57 77 64 59
Health facilities knowing correct equipment and knowledge of processing time(%) 67 94 50 69
Health facilities with trained staff (%) 95 77 92 94
Health facilities having "Swastjya sewako gunathar sudhar padhatee" QA guideline(%) 21 16 17 20
Health facilities having clinical protocol (%) 14 0 13 13
Health facilities having all four tracer amenities (%) 59 93 73 62
Health facilities having a waiting room (%) 74 92 66 75
Health facilities having tracer Medicine (%) 42 27 50 41
Health facilities with all nine items (%) 1 0 0 1
Nepal Health Facility Survey 2021

Health Service Quality

Observed Family Planning Consultations

Observed Sick ChildConsultations

Nepal Health Facility Survey 2021

Physical Examinations and Counseling for ANC clients

Nepal Health Facility Survey 2021

Health Equity

Ethnicity and wealth-wise service recipient status

Caste Group NEONATAL MORTALITY RATE/1000 LB UNDER 5 MORTALITY RATE/1000 LB TOTAL FERTILITY RATE % OF CHILDREN UNDER 5 STUNTED % OF WOMEN 15-49 YEARS WITH BMI <18.5 % OF CHILDREN FULLY IMMUNIZED % OF INSTITUTIONAL DELIVERY % OF DEMAND SATISFIED FOR FAMILY PLANNING % OF DIARRHEAL DISEASES IN UNDER 5 YEARS CHILDREN % OF ANEMIA IN WOMEN 15-49 YEARS
Dalit 63 43 3 40 21 73 45 63 8 38
Janajati 42 24 2 32 12 83 58 71 7 40
Madheshi 51 27 3 42 28 64 48 72 10 56
Mushlim 47 25 4 38 31 68 52 53 11 52
Brahmin/Chettri 39 23 2 35 15 87 68 69 6 37
Newar 33 9 2 27 9 89 75 74 12 26
National Average 39 21 2 36 17 78 57 69 8 41
Province Average 58 29 3 55 15 75 36 58 6 35
Poor household 61 32 3 59 0 73 28 57 6 36
Middle income Household 0 0 2 33 0 0 82 66 4 28
Wealthy household 0 0 2 32 0 0 86 57 10 33
Nepal Demographic and Health Survey 2016/79

Utilization of major MNCH and FP health services

Indicators Household Wealth Ethnic Group
Poor Middle Wealthy Advantaged Disadvantaged Provincial Average National Average
Use of any Modern Method of Family Planning (%) 43 53 47 45 43 45 43
Percentage of women who had any ANC visit 83 99 97 84 88 85 94
Percentage of women who had 4 or more ANC visits 47 75 90 49 58 52 69
Percentage delivery in a health facility 28 82 86 30 46 36 57
Percentage delivered by a skilled birth attendant 28 84 82 31 44 35 58
Delivery assisted by noone 11 2 0 12 5 10 10
Percentage of women who reported getting permission to go for treatment as a problem in accessing ca 37 18 10 33 33 33 24
Percentage of women who reported getting money for treatment as a problem in accessing care 64 48 29 61 56 59 55
Percentage of women who reported distance to health facility as a problem in accessing care 81 45 28 74 69 72 53
Percentage of women who reported not wanting to go alone as a problem in accessing care 83 69 52 79 78 79 68
Percentage of women who reported no female health service provider as a problem in accessing care 70 57 45 68 65 67 67
Nepal Demographic and Health Survey 2016

Indicator- Achievement and Target

Indicators Provincial Natinal Target 2025 Target 2030
Maternal mortality ratio - 239 86 70
Pregnancy related mortality ratio - 259 - -
Teenage Childbearing rate 81 63 - -
Under-five children mortality rate 30 28 26 20
Infant Mortality Rate 27 25 - 10
Neonatal mortality rate 11 16 14 12
Total fertility rate 3 2 2 2
Contraceptive prevalence rate, modern methods 36 36 33 75
Institutional Delivery Rate 78 66 78 90
Rate of delivery by skilled birth attendant 63 62 79 90
Children, fully immunized rate 70 70 100 100
Children stunting rate 48 32 22 15
Children wasting rate 18 12 6 3
Life Expectancy at birth (Years) 67 69 - -
HIV Prevalence Rate 1 - - -
2018

Utilization of Priority MNCH FP Services

Health Management Information System 2078/79

Trend of Utilization of Priority Health Services

Indicators Karnali Pradesh National 2076/77  
2076/77 2077/78 2078/79  
Immunization
Graph Table
BCG Coverage 93 107 92 86  
DPT-HepB-Hib 3 coverage 89 101 94 78  
Measles/Rubella 1(9-11 m) Coverage 90 95 95 80  
JE Coverage 86 96 95 78  
TD2 and TD2+ Coverage 65 73 66 59  
Nutrition
Graph Table
% of newborns with low birth weight (<2.5Kg) 6.3 7 6.8 13  
% of children aged 0-11 months registered for new growth monitoring 106. 118.1 119.4 77  
% of children (0-23m) registered for growth monitoring who were underweight 5.1 3.6 4.1 6.5  
% of women who received 180 days’ supply of Iron folic tablets 58.4 73.7 72.3 44  
% of Post-partum women who received Vitamin A 85.7 92.6 88.4 57  
CB-IMNCI
Graph Table
% of newborn applied with Chlorohexidine 95.3 81.3 95.5 79  
% of PSBI cases treated with full dose of Gentamicin 67 65.5 75.4 45  
Incidence of Pneumonia/1000 Under 5 years children 148.2 94.9 112.5 70  
% of severe Pneumonia among New ARI cases 0.37 0.24 0.41 0.22  
Incidence of Diarrhoea/1000 Under 5 years children 626.9 625.6 576.9 350  
% of Under 5 Children with Diarrhea treated with ORS and Zinc 95.8 96.3 93 95  
Number of Neonatal death 208 218 199 1779  
Safe Motherhood and FP
Graph Table
% of pregnant women who attended ANC 1st visit 89 91 89.9 68  
% of pregnant women who attended ANC 4th Visit as per protocol 65.6 76 72.3 53  
Institutional delivery rate 140.1 156.6 152.2 66  
SBA delivery rate 62.6 69.5 69.8 62  
% of 3rd PNC visit as per protocol 29.4 40 52.6 19  
Number of Maternal death 21 20 17 215  
FP Methods New acceptor among as % of MWRA 19 19.4 18.7 11  
Malaria, TB, Leprosy and HIV
Graph Table
Malaria Slide Positivity Rate 0.46 0.47 0.25 0.25  
% of imported malaria 73 50 62.5 84  
Proportion of Plasmodium Falciparum Malaria 5.9 5.9 2.1 9  
TB case Notification rate(all form of TB) 68.8 65.3 97.2 91  
TB Treatment Success Rate 86.4 93.4 90.9 90  
Leprosy Incidence Rate /10000 population 0.31 0.37 0.4 0.9  
Number of HIV +ve patients on ART 602 651 690 50767  
Curatives
Graph Table
% of OPD New Visits among total population 101 103 104.5 84  
Non-Communicable Diseases
Graph Table
COPD cases 23373 30985 20608 0  
Cancers cases 71 143 19 0  
Diabetes cases 5995 6598 6604 0  
Renal Failure 445 240 154 0  
Ayurvedic Services
Graph Table
Total OPD cases 59952 103046 0 0  
Total Panchakarma Service client 7327 9376 0 0  
Total Male client served 63577 0 0 0  
Total Female Client Served 48600 0 0 0  

Top 10 Health Conditions

Health Management Information System 2078/79

Behavioral Risk Factors

Risk Factors Provincial National
Tobacco
Percentage who currently use tobacco(smoked/smokeless) 30 29
Percentage who currently smoke tobacco daily 16 13
Alcohol Consumption
Percentage who engage in heavy episodic drinking (6 or more drinks on any occasion in the past 30 da 9 7
Percentage who currently drink (drank alcohol in the past 30 days) 20 21
Percentage who are lifetime abstainers 0 0
Diet
Percentage who ate less than 5 servings of fruit and/or vegetables on average a day 97 97
Salt
Mean Intake of salt per day (in gram) 10 9
Physical Activity
Percentage with insufficient physical activity (<150 minutes of moderate intensity activity/week or 4 7
Oral Health
Percentage who reported an issue pain, swelling and discomfort with teeth/gum/mouth 22 14
Cervical Cancer Screening
Percentage who ever had a test for cervical cancer (female only) 16 8
Violence and injury
Percentage involved in road traffic crash in the past 12 months 5 14
Body Mass Index
Mean body mass index (BMI (kg/m2) 21 23
Percentage of who are overweight and obese (BMI <25 kg/m2) 11 24
Hypertension, Diabetes and Raised Cholesterol
Percentage with raised BP 21 23
Percentage with raised fasting blood glucose 1 6
Prevalence of raised total cholesterol 5 11
Percentage of people (40-69 years of age) who ever got their BP measurement from a health worker 43 61
Percentage of people (40-69 years of age) who ever got their blood sugar measurement from a health w 9 21
Nepal STEPS Survey 2019

Epidemics, diseases, and Outbreaks

District 2074/75 2075/76 2076/77 2077/78 2078/79
DOLPA RTA, Flood/Landslide, Typhoid Fever
MUGU ILI, Fever, Malaria Diarrhea, Malaria Kala-azar, RTA
HUMLA Fire, Influenza Landslide, RTA, Influenza Kala-azar, RTA
JUMLA RTA, Diarrhea, Influenza Kala-azar, RTA
KALIKOT Influenza Fire Dengue, Scrub Typhus, Kala-azar, RTA, Landslide
DAILEKH Thunderbolt, RTA Dengue, Scrub Typhus, Kala-azar, RTA, Landslide
JAJARKOT Influenza Landslide, RTA, Diarrhea Scrub Typhus, RTA, Landslide
RUKUM WEST Fever Unknown Diseases, HF vandalized, MCD Scrub Typhus, RTA, Landslide
SALYAN RTA, House Collapse, Fire Dengue, Scrub Typhus, Kala-azar, RTA, Landslide
SURKHET Jackal Bite Diarrhea, Thunderbolt, MCD, Food poisoning Dengue, Scrub Typhus, Kala-azar, RTA, Flood, Landslide

Partners in Health

Name of Partners Geographic Coverage Focus Theme
AIDS Health Care Foundation Nepal Provincial Hospital HIV/AIDS
ASCEND All Districts Neglected Tropical Diseases
CMC Nepal 5 Districts Mental Health
Global Health Supply Chain- Procurement and Supply management All Districts Supply Chain Management
HKI-SUAAHARA II 5 Districts Nutrition, WASH and Agriculture
INF International All Districts TB and Leprosy
IPAS 2 Districts Sexual Reproductive Health & Right
Nepal Red Cross Society All Districts WASH & Health Emergency
Nick Simons Institute All Districts Hospital System Strengthening
PHASE Nepal Mugu and Humla Districts Reproductive, Maternal, Newborn, and Child Health
Plan International Jumla District Early Childhood Development
Save the Children 4 Districts Reproductive, Maternal, Newborn, and Child Health
SNV (Swachchhata) 4 Districts WASH and SBCC
TPO Nepal 5 Districts Mental Health
UNDP All Districts Health Emergency
UNICEF All Districts Health, Nutrition, and WASH
USAID Strengthening Systems for Better Health Activity All Districts Health System Governance, Health Information System, and Maternal, Newborn, Child Health and Family Planning
WaterAid All Districts WASH
World Food Programme All Districts Food Security, Nutrition, & Health Emergency
World Health Organization All Districts VPD and Routine Immunization, Public Health Emergency, and Health System Strengthening
Building Hope Along the Karnali River Basin (BHAKARI), Mercy Corps 5 Districts Food Security, Disaster Risk Reduction, Emergency
Handicap International All Districts Physical rehabilitation
2077

Important Contact Information

Karnali Pradesh

Address : Birendranagar, Surkhet

Telephone : 083-520216

Website : https://hsd.karnali.gov.np/

Director

Name : Dr. Rabin Khadka

Contact : 083520216

Email : dockhadkarabin6000@gmail.com

This profile is made possible by the support of the American People through the United States Agency for International Development (USAID). The contents of this profile are the sole responsibility of Strengthening Systems for Better Heath and do not necessarily reflect the views of USAID or the United States Government.