In Kalikot district of Karnali, the District Public Health Office (DPHO) has distributed nutritious flour provided by the Child Health Division (CHD) of the Ministry of Health and Population (MoHP) only in 16 of the total 30 Village Development Committees (VDCs).[break]
“As of now, we have distributed fortified flour only in VDCs close to the Karnali highway,” said Dhirjung Shah, chief of Kalikot DPHO. “Even in the VDCs linked by roads we have dropped fortified flour sacks only at certain points. We have still been unable to develop mechanism for supplying fortified flour to each and every household.”
In Jumla, another district of Karnali, babies under the age of two in nine of the total 31 VDCs are yet to get fortified flour, which was supposed to have been distributed by the end of the last fiscal year. “We have sought additional budget for distribution of fortified flour in the nine VDCs,” said Roshan Lal Chaudhary, chief of the Jumla DPHO.
According to Dr Shyam Raj Uprety, Chief of CHD, all the five DPHOs in Karnali have demanded additional budget for supplying fortified flour to the VDCs. However, Dr Uprety says, the CHD cannot allocate additional budget for the purpose to any district of Karnali.
DPHOs have been facing difficult supplying fortified flour to all the VDCs as they do not have adequate budget for local transportation. In the first two years following the government´s announcement to provide nutritious food to all children under the age in Karnali, the Nepal Family Health Program (NFHP), supported by USAID, helped DPHOs transport fortified flour sacks form district headquarters to the VDCs.
With the term of NFHP expiring and CHD doubling the amount of fortified flour from the last fiscal year, distributing nutritious food to every VDC in Karnali has become a tall order. “Most VDCs in our district do not have access to roads,” says Kalikot DPHO chief Shah. “We hire mules to transport anything to the villages. Therefore, the cost of local transportation is very expensive.”
However, CHD has sanctioned inadequate budget for local transportation of fortified flour. In Jumla, where over 80,000 kgs of fortified flour have been supplied, CHD has allocated only Rs 700,000 for local transportation. “With this money, we transported around 40,000 kgs of flour to several VDCs,” said Jumla DPHO chief Chaudhary. “We need at least Rs 450,000 to supply all flour-sacks.”
Prithvi Nath Yogi, chief of nutrition section at the Jumla DPHO, said, “As we lack budget for local transportation, we can neither supply the remaining sacks of flour to all the VDCs nor can we dispose of them.” According to Yogi, CHD is supplying an additional 500 quintals of flour to Jumla.
“This is ridiculous as we have already been facing difficulty transporting the already-supplied flour sacks,” he says. According to the National Demographic Health Survey (NDHS) 2011 report, 41% of children under the age of five are stunted. In the mid-western hills, which include Karnali, the percentage of stunted children is 52% -- higher by 11% than the national average.
Three years ago, the government had announced an ambitious plan to provide fortified flour to all children below the age of two in Karnali with the objective of tackling malnourishment.
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