Socio-cultural, Historical Factors Affecting Health in Nepal Essay

This argumentative essay examines the critical health challenges faced by Nepal, focusing on the rising incidence of non-communicable diseases and premature mortality. It delves into the influence of socio-cultural, historical, and structural factors on health outcomes, providing a detailed analysis of each. The essay highlights specific factors such as cultural beliefs, lack of healthcare access, poor economic conditions, historical events, and structural limitations that contribute to the problem. It also presents a success story of Nepal's efforts to reduce premature mortality through policy implementation and healthcare system improvements. The essay concludes with recommendations for further interventions, including educational programs, health awareness campaigns, and legal reforms, to improve health outcomes and reduce mortality rates. The essay references numerous sources to support its arguments and provide a comprehensive overview of the topic.

Argumentative Essay

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
Effects of Socio-cultural, historical and structural factors on health issues of non
communicable disease............................................................................................................1
Critical analysis of each factor...............................................................................................4
A success story.......................................................................................................................4
Recommendations..................................................................................................................5
Conclusion.......................................................................................................................................5
REFERENCES................................................................................................................................7

INTRODUCTION
In recent times, there has high rise in increase in death of children and infants due to
communicable diseases. Basically, it is affecting on nation where there is poverty and social life
of people is highly poor. A non communicable disease includes all those which does not spread
from person to person Naz, Page. & Agho, (2018). . For example, Nepal, South Africa, etc.
There are various types of communicable diseases such as HIV, hepatitis B, measles, etc which
spread quickly within community. It spreads due to poor social life, environment etc in which
they live. Along with it, there are many other factors as well which is affecting on this health
issues such as historical, cultural etc many organizations have taken initiative as well to address
the health issue of these diseases. For instance, UN, WHO, work together with other countries
government. For that social determinant of health are taken as framework to solve health issue.
The issue must be resolved so that people life is improved. There are various initiative and
strategies taken for it. From that outcomes are attained but they are not effective. In this report it
will be described about progressive of Nepal to the UN sustainable development goal and ways
by which they have reduced premature mortality rate along with effect of Socio-cultural,
historical and structural factors on health issues Tulloch, Machingura, & Melamed, (2016).
.
MAIN BODY
The progressive of Nepal to the UN sustainable development goal, main target is reducing by
one third premature mortality from non-communicable diseases through prevention and
treatment and promote mental health and well-being by 2030.
Effects of Socio-cultural, historical and structural factors on health issues of non communicable
disease
There are several developing countries where increasing mortality rate is becoming the main
issue of non communicational diseases Union (2020). There are several factors which lead to this
rate such cultural background, lack of access to healthcare, poor economic condition and others.
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Underhill& Singh-Peterson, (2017). All these can affect future generation to the great extent in a
negative manner but it is found that Nepal is taking effective actions regarding this and
improving several areas.
United nation, sustainable development growth, target by 2030 is focusing on reducing deaths of
infants and newborns rate Non communicable disease rate in Nepal,(2018).There were around
121,000 premature mortalities from NCD and it is estimated to account for 66% of all deaths
Das, (2017). There were several reasons and risk factors such as: harmful uses of alcohol,
Physical inactivity, blood pressure, diabetes, obesity and other. Blood pressure and tobacco use
is one of the main risk factors of increasing mortality Chan, (2019).
In the recovery rate and improvement rate it is found that there is in total 25% reduction
in overall mortality from non communicational diseases like cancer, respiratory and other by
2025. This goal will be achieved by focusing on each of risk factor and in this regard it is stated
that Nepal is focusing on reducing 10% reduction in harmful uses of alcohol as well as physical
activity, 25 % reduction in prevalence of raised blood pressure by the year of 2025National NCD
targets for Nepal,(2017).
Nepal is a small Himalayan country which was having high prevalence of NCD and one of the
main reasons behind mortality rate in NCD is higher level of alcohol and tobacco use, changes in
dietary patterns, behavioural factors and others Peters, Woodwar, Jh. & Kennedy, (2016).
Historical factors
In the context of historical factors lower respiratory infection is found one of the main reason of
increasing mortality rate in Nepal. Increasing uses of drugs and alcohol by people and also by
pregnant women also leading to premature mortality rate in infant. There is a history of years
lived with disability in which there are some leading causes such as: lower back pain, depressive
disorder, pulmonary diseases and migraine . It is also found that premature death in children
under 5 years and adults of 15-49 years are underweight. It all happens because of war and
disaster. World Health Organization. (2019).
Communicable and neonatal conditions remain significant public health issues in Nepal. Due to
the location, magnitude and other historical factors most of the wars have been happenedhere
and natural disaster is also one of the main reason which cause to lack of healthcare access to
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people, poor economy. These main reasons are causing pre mature mortality as people find
problems in having nutritional food and education as well Gunilla Backman, (2018).
.
Cultural factors
In the context of pre mature and neonatal mortality rate it is stated that this mountain
region has 46 per rate on per 1,000 live births, with 85% of all neonatal deaths occurring within
the first week after birth. It is higher in this place because of underestimation of stillbirths. There
are several cultural and social believes regarding stillbirth which causes this increasing rate and
in this regard it is found that some people believe that Perinatal death is a natural and saving
child at the time of delivery and after delivery is not in our hand as it is all about fate and destiny.
By having such thinking people do not get effective healthcare services which is required for
pregnant women and due to lack of awareness and orthodoxy thinking it is leading pre mature
mortality rate.
In survey some participants of Nepal shared their views and said that theirfamily
members has lost 2 babies, 5 babies, 3 babies and it is a common phenomenon that everyone
faces. So, it is all about low level of concern about early life, lack of care of pregnant women,
thinking like this and also connecting this death with fate is all cultural believes and it is
affecting people as whole Religio-Cultural Factors Contributing to Perinatal Mortality in
Mountain Villages of Nepal,(2018).
Structural factors
Structure factors is one of the main reason in Nepal as it is all related to access to healthcare, lack
of resources availability and poor economic condition due to war and natural disasters. In the
regards to infant mortality rate it is stated that it was around 48 and 46 per 1000 live births for
2006 and 2011. It is also found that in Nepal there is lack of educational sources for women and
due to lack of knowledge, women residing in the mountains, who did not use contraceptives, lack
of education are more likely to affect with stillbirth and infant mortality rate. They do not take
care of themselves due to lack of knowledge and thinking of people are also not concerned with
stillbirth so, it all causes to infant and pre mature mortality rate Chauffour, (2017)
.
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Lack of availability of qualitative healthcare systems for both mothers, infants and also due to
lack of education there is lack of human resources in medical field Goli, Bhandari, Atla, &
Chattopadhayay, (2017).
. In addition, it is also found that due to lack of finance and poor economic conditions many
people or pregnant women use biomass as cooking fuel and also do not focus on sanitization
which is increasing PM and EPM in Nepal. Factors Associated with Perinatal Mortality in Nepal,
(2019). So, overall it can be said that quality of women’s education which is limited in Nepal for
women, lack of healthcare access due to poor economic condition, unemployment, family beliefs
regarding still birth are all factors associated with this mortality rate.
Critical analysis of each factor
In the context of improvement, it is stated that government of Nepal of 3 tier is focusing on
management and planning of resource by which people can get easier access to healthcare. But
still due to orthodox mentality and other reasons like natural disaster it will take time to
accomplish United Nations, sustainable development growth. All structural, socio-cultural
factors like lack of education, increasing use of alcohol are increasing this risk.
So, overall it can be said that effectiveness is limited due to poor economic condition. By
increasing use of drugs therapies on which government is focusing, free healthcare access.
Reducing migration, all negative effects on health can be reduced.
A success story
There has been a substantial reduction in premature avertable mortality from non
communicational disease. Nepal is counted in the top 3 countries with having high rates of
premature avertable mortality from NCDs but their initial and effective steps like increasing use
of drugs therapies, access to healthcare systems. In this regard it is found that around 50% of
eligible people are getting drug therapy as well as counselling in order to prevent patients against
heart attacks by the year of 2025.
In addition, around 80% of affordable technologies, healthcare access, appropriate medicines
which are required for treating NCDs in public facilities and by doing so, they are going to
reduce mortality rate. Nepal has taken several actions regarding reducing this rate by ratification
of national policy 2009. Marquez,(2016).Plan of action 2014. By implementing all these policies
by evaluating in a detailed manner, allowing all people to have easy access to healthcare system,
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free healthcare for low income of people are some strategies which are making it able to reduce
this mortality rate.
Healthcare system: It is stated that in the year of 2017 health system faced a drastic
transformation. This country has 3 tiers of government which all together are playing role in
resource planning and management in this area. Under these governments, local communities
can have direct services. They have also launched the package of required NCD which is being
developed by WHO in 2016 for early detection as well as management of chronic
diseasesBuilding Strong Primary Healthcare to tackle Growing Burden of Non-Communicable in
Nepal,(2020).So, overall it can be said that by providing access, increasing awareness in people
about leaving drugs and all, Nepal has reduced mortality rate.
Recommendations
On the basis of above study and discussion some factors have been identified which are
increasing premature and infant mortality rate. So, in this regard it can be recommended that
government should focus on developing educational programmes for pregnant women,
compulsoryeducation for girls, employment to all age group of people, awareness in people
about requirement of care of pregnant women and reducing rate of stillbirthSocio-cultural
Factors Associated with Mortality,(2015). It is also found that main risk factors are household air
pollution, tobacco use and underweight so, in this regards it can be recommended that
Government should focus on developing smoke quit and other health awareness program. By
making able to adults to participate in quit smoking, alcohol and such programme, they can
reduce this rate and prevent them against premature death and mortality rate.
In addition, it is also recommended that government should reinforce new legal age of marriage
as Nepal has the 3rd highest rate of child marriage as around 37% of girls marry before the age of
18 and 10% before 15%. They are nit mature in this age and also do not have proper knowledge
about pregnancy and all which is leading all issues and stillbirth Davidso,(2019).
Conclusion
From the above study it has been summarized that policies and access to healthcare played a
vital role in improving overall health of people and reducing premature mortality rate. Premature
mortality affects the whole society in a negative manner. Further, this study has discussed som
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risk factors and reasons which are associated with premature mortality rate in Nepal along with
actions taken by the government.
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REFERENCES
Books & Journals
Chan, E. Y. Y. (2019). Disaster public health and older people. Routledge.
Chauffour, J.P., 2017. Investing in Human Capital.
Das, S. (2017). The health care system in India. In Health Care Systems in Developing Countries
in Asia (pp. 149-182). Routledge.
Davidson, L. (Ed.). (2019). The Routledge Handbook of International Development, Mental
Health and Wellbeing. Routledge.
Goli, S., Bhandari, P., Atla, U. M. R., & Chattopadhayay, A. (2017). Childhood mortality
differentials by ecological region in Nepal. Population, Space and Place, 23(2), e1977.
Gunilla Backman, I. (2018). Mental health workers' perceptions and perspectives on the right to
health and a human rights-based approach to mental health: A case study of the
Chitwan District in Nepal (Doctoral dissertation, London School of Hygiene & Tropical
Medicine).
Marquez, P. V. (2016). Mental health among displaced people and refugees: making the case for
action at the World Bank Group. World Bank.
Naz, S., Page, A., & Agho, K. E. (2018). Potential impacts of modifiable behavioral and
environmental exposures on reducing burden of under-five mortality associated with
household air pollution in Nepal. Maternal and child health journal, 22(1), 59-70.
Peters, S. A., Woodward, M., Jha, & V., Kennedy,(2016). Women's health: a new global
agenda. BMJ global health, 1(3).
Tulloch, O., Machingura, F., & Melamed, C. (2016). Health, migration and the 2030 Agenda for
Sustainable Development.
Union, I.P., 2020. Road map for action on women’s, children’s and adolescents’ health.
World Health Organization. (2019). Programme Budget 2018–2019: Implementation and mid-
term review (No. SEA/RC72/4). World Health Organization. Regional Office for South-
East Asia.
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ONLINE
Non communicable disease rate in Nepal.2018. Online Available through:
<https://www.who.int/nmh/countries/npl_en.pdf?ua=1>
National NCD targets for Nepal.2017. Online Available through:
<https://extranet.who.int/ncdccs/Data/NPL_Nepal_NCD_targets.pdf>
Global Burden of Disease in Nepal. 2013. Online Available through:
<https://www.healthdata.org/sites/default/files/files/country_profiles/GBD/
ihme_gbd_country_report_nepal.pdf>
Religio-Cultural factors Contributing to Perinatal Mortality in Mountain Villages of Nepal.2018.
Online Available through:
<https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0194328>
Factors Associated with Perinatal Mortality In Nepal.2019. Online Available through:
<https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2234-
6>
Building Strong Primary Healthcare to tackle Growing Burden of Non-Communicable in
Nepal.2020. Online Available through:
<https://www.tandfonline.com/doi/full/10.1080/16549716.2020.1788262>
Socio-cultural Factors Associated With Mortality. 2015. Online Available through:
<file:///C:/Users/Administrator/Downloads/17934-Article%20Text-58248-1-10-
20170803.pdf>
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