Article Text

Download PDFPDF
Lessons from the field: progress towards the sustainable development goals in Nepal in federal transition of the state
  1. Ashish KC1,2,
  2. Amit Bhandari3,4
  1. 1 Women's and Children's Health, Uppsala University, Uppsala, Sweden
  2. 2 Society of Public Health Physicians Nepal, Kathmandu, 3, Nepal
  3. 3 Golden Community, Lalitpur, Nepal
  4. 4 Society of Public Health Physicians Nepal, Kathmandu, 3, Nepali
  1. Correspondence to Dr Ashish KC, Women's and Children's Health, Uppsala University, 752 36 Uppsala, Sweden; aaashis7{at}

Statistics from


In Nepal, despite the decade-long internal conflict and unstable governments during the Millennium Development Goal (MDG) period, the progress in reducing maternal and child deaths has been praiseworthy. The under-five mortality reduced from 146 per 1000 live births to 42 per 1000 live births, and the maternal mortality ratio reduced by more than half between 1990 and 2015.1 More than 85% of the children were fully vaccinated as per national schedule in 2015.2 However, the progress was not uniform and disparities were considerable across different social, economic and geographical population groups. A large inequity gap was witnessed in skilled attendance at birth between the wealthiest and poorest families in 20162 (figure 1). The coverage of skilled attendance at birth was more than 90% among the women from the wealthiest families, but less than 40% among the women from the poorest families. Similarly, the wealthiest families have achieved neonatal mortality rate target for SDG, 12 per 1000 live births in 2017, while the poorest families will take an estimated further 40 years to achieve it.1

Figure 1

Coverage of reproductive, maternal, neonatal and child health intervention between poorest and wealthiest quintiles in 2016. ANC, antenatal care; BCG, Bacillus Calmette–Guérin; DPT3, third dose of diphtheria, pertussis and tetanus; ORT, oral rehydration therapy; SBA, skilled birth attendance.

Nepal has …

View Full Text


  • Twitter @ashish_K_C

  • Contributors AKC wrote the first draft and AB revised the first draft. Both authors agreed on the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.