Backward region: A Glance


If Nepal's development efforts can be considered as a partial success, Karnali's development is still a total failure. Various indicators of human development indicate that the nine districts of this region ( as per Karnali Academy of Health sciences Act 2068) are in the lowest ranking group within the country both in relative and absolute terms (Table 1). In another words, most of Nepal's underdeveloped districts are located in Karnali Zone. All nine districts Jumla, Humla, Mugu, Dolpa, Kalikot, Bajhang, Bajura, Achham and Jajarkot occupy the last (Less than 0.400) positions in terms of Human Development Index among the districts of Nepal. The HDI of Nepal is 0.458. The sorry state of affairs in terms of the difficulties faced by the majority of the people in maintaining their livelihood in Karnali raises questions about the impact of development endeavors there. But most of the expenditures spent on food subsidies and salaries of the government personnel. Moreover, because of the lack of good all season roads, transporting things to these districts is itself a difficult task. For example, a bag of cement which cost Rs 400 in Nepalganj cost Rs 1000-2000 in Karnali in 2013. This also makes it difficult to successfully implement development projects in Karnali.

In all the indicators of health, the districts of Karnali are far behind the average scenario of Nepal. For example, about 60% of children (below 5years) in Jumla, Humla, Mugu, Kalikot, Bajhang and Bajura suffer from stunting (Table 1).

Acute malnutrition rate is in between 8% to 14% in these nine districts. Severe malnutrition rate is between 2.5% to 9% in these districts.

Anemia in below 5 years children is from 36% to 53%. Only two districts Achham and Jajarkot has 41% and 36% anemia in below 5 years of age children. But rest of the districts have 53% of anemia Similarly Achham and Jajarkot have anemia rate in women (15-49 years) is 29% and 23%. Other all districts have 33%. Regarding the causes of malnutrition and anemia the study found that it was not only due to lack of access of food but also poor breast feeding practices and poor hygiene and sanitation.

Karnali Academy of health Sciences (KAHS) is situated in Chandanath VDC of Jumla district. Jumla district is supposed to be one of the more accessible and developed district among all these nine districts. The comparison between Jumla and Nepal is given Table 2. Three most important health indicators like Infant mortality rate, Maternal mortality ratio and Life expectancy at birth of Jumla are far below than national figures. This indicates the backwardness of Jumla district and lag behind in national main stream. We can imagine the condition of other districts in these health indicators.

Various reasons have been identified for the total lack of development in Karnali region. They include both physical (and geographical) and social factors. But the social, including political, reasons have greater consequences than the geographic. Even though geography does not pose a problem if there is enough commitment from society and the polity, it does, however, determine the potentiality of a region in the early stages of development. Karnali occupies about 15% area of the country but accommodates 2% of the population. The density is extremely low, 12 persons per sq km. Because of spars population density and extremely scattered settlement patterns, it is costly and difficult to provide electricity, water, telephone, and transportation facilities to all inhabitants. The other fact is that Karnali is now dependent on Kathmandu for decision making and investment because there is no autonomy in planning and development, and local resources are not used for the development of Karnali.

Therefore, this region is idenfied as "Backward region"

Table :-1. Indicators of Nine Districts of Karnali Region





























































































































































Indicators Jumla Humla Mugu Dolpa Kalikot Achham Bajhang Bajura Jajarkot
HDI 0.348 0.367 0.304 NA 0.322 0.35 0.311 0.31 0.343
Literacy Rate 55% 62% 65 % NA 57 % 53 % 56 % 56% 57%
Woman Literacy Rate 41% 48% 51 % NA 45 % 37 % 40 % 43% 49%
Total Development Budget 2,529, 387,000 NA 1,104,476,000 NA 591,524,000 3,106, 819,000 1,777,386,665 1,383,691,465 490,458 625
Contraceptive prevalence Rate 41% 35 % 30 % NA 21 % 19 % 27% 32% 34%
Measals Vaccine Coverage 105% 91 % 115 % NA 109 % 123 % 106% 103% 132%
Delevery by SBA as %of expected Pregnancy 24% 38 % 47 % NA - 25 % 21% 35% 17%
Prevalence of stunting 60% 60 % 60 % NA 60 % 55 % 60% 60% 52%
Global Acute Malnutrition 13% 13 % 13 % NA 8 % 14 % 13% 14% 13%
Severe Malnutrition 4.4% 9 % 4.4 % NA 3.4 % 2.5 % 2.5% 2.5% 4.4%
Anaemia in <5 years children 53% 53 % 53 % NA 53 % 41 % 53% 53% 36%
Anaemia in woman 15-49 years 33% 33 % 33 % NA 33 % 29 % 33% 33% 23%


NA – Not Available
Source:- United Nations Field coordination office (UNFCO), Mid Western Region, Nepalganj, Nepal - 2012


Table 2 M– Comparison between Health Indicators of Jumla and Nepal














































Health Indicators Jumla Nepal
Annual Population Growth Rate 1.63 1.35
Average Life Expectancy 47 years 64.1 years
Crude Birth Rate 33.6 24.3
Crude Death Rate 9.6 8.3
Total Fertility Rate 4.2 2.6
Infant Mortality Rate 61.5/1000 Live Births 46/1000 Live Births
Under 5 years Mortality Rate 59/1000 Live Births 54/1000 Live Births
Maternal Mortality Ratio 400/1,00,000 Live Births 281/1,00,000 Live Births


Source - Jumla - District Health Office, Jumla- 2011
- Nepal - Central Bureau of Statistics - 2012
- MDG Report, MOH&P, Nepal - 2013