nurse essay in nepali

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मेरो जीवनको लक्ष्य

मानिसले जीवनमा किन लक्ष्य बनाउँछ, किन सानै देखि बनाउँछ , किन धेरै बनाउँछ । यो बनाउनुको कारण भविष्यमा गएर राम्रो काम गरी आफ्नो परिवारलाई खुशी पारी राम्रो भविष्य बनाउनका लागि हो । मानिसले यो लक्ष्य बनाउनका लागि हो। मानिसले यो लक्ष्य बनाएर यस्तो फल आउँछ भनेर जीवनको लक्ष्य पहिलेदेखि नै राखेका हुन्छन् । मानिसले लक्ष्य दिमाग लगाएर आफ्नो भविष्य उज्ज्वल हुने गरी बनाउँछ । मानिसले यी लक्ष्य आफ्नो जिविका चलाउनको लागि मात्र नभई अरुलाई सेवा गर्नका लागि, अरुको भलाइका लागि पनि सोचेका हुन्छन् । ठूला ठूला मानिस सफल हुनुका कारण सानैदेखि लक्ष्य लिएर प्रयास गर्नु हो । मानिसहरु विभिन्न लक्ष्य रोज्छन् तर म डाक्टर बन्न चाहन्छु । मलाई लाग्छ डाक्टर बनेपछि सबै थोक हुन्छ । तर सबै थोक हुन्छ वा हुँदैन म पक्का छैन । म त चाहन्छु कि सबै मानिसले बढी मात्रामा पानी खाएर, सागपात खाएर, पोषणयुक्त खाना खाएर डाक्टरको आवश्यकता नै नपरोस् । म डाक्टर बनेर पैसा पनि कमाउन चाहन्छु, परिवारलाई मात्र नभई सारालाई खुसी पार्न चाहन्छु । गरिब, दिन दुःखी छन् र उनीहरुको स्वास्थ राम्रो छैन तर उनीहरुसँग उपचार गर्ने पैसा नभएर उपचार नगरिकन बसेको छ भने निःशुल्क उपचार गरिदिन्छु । जुन ठाउँमा अस्पताल छैन त्यहाँ अस्पताल बनाउछु र त्यस ठाउँमा मानिसलाई उपचारका लागि भनेर टाढा टाढा जान नपरोस् । यो मेरो काम देखेर सबै मानिस खुसी हुन्छन् भन्ने लाग्छ । मलाई मेरो बुबा, हजुरबुबाहरुले पहिलेदेखि नै डाक्टर बनेर यस्तो काम गर्नुपर्छ भनेर मलाई पहिलेदेखि नै भनिराख्नुभएको थियो । तर मलाई डाक्टर बन्ने मन थिएन । जब म कक्षा ४ मा पढ्दथेँ। मलाई कक्षा ४ मा पढाउने नेपाली शिक्षकले भन्नुभएको थियो कि “सेवा नै धर्म हो” सबै मानिसलाई सेवा गर्नुपर्छ र सेवा गरेर ठूलो मान्छे बन्नुपर्छ । र, मैले त्यही बेलादेखि सोचे म डाक्टर बनेर यस्तो गर्नुपर्छ भन्ने त्यसदेखि मनमा सोचिरहेँ । म अझैँ पनि डाक्टर बन्ने मनमा सोचिरहेको हुन्छु । म अवश्य नै माथि बोलेका कुराहरु पुर गर्नेछु । म डाक्टर बन्न अहिलेदेखि नै मिहिनेत गरेको छु र अझै बढी मिहिनेत गर्ने छु । भनिन्छ , “मन लगाएर आँटेको कुरा अवश्य सफल हुन्छ”। यति भन्दै मेरो कलम यही बन्द गर्दछु । धन्यवाद ।

नयन भण्डारी

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Migration of Nepali Nurses to Foreign Countries: An Emerging Trend

Career 02 Jun 2024 106 0

Increasing Migration of Nepali Nurses

Human resources in Nepal, particularly those who have studied nursing, are increasingly migrating abroad due to the lack of opportunities within their own country. This trend is driven by the need to find better working conditions and remuneration, which are often unavailable in Nepal.

Preferred Destinations for Nepali Nurses

Initially, developed countries such as the United States, Canada, Australia, and the UK were the primary attractions for Nepali nurses. However, there has been a recent shift towards Gulf countries, including Saudi Arabia, Dubai, Qatar, and Kuwait. Treasurer of the Nepal Nursing Council, noted this trend, emphasizing that nurses are drawn to these countries due to the better income prospects with minimal expenses.

Consequences of Migration on the Domestic Healthcare Sector

Shrestha expressed concern that if this migration trend continues, Nepal might face a shortage of nurses. Nurses are compelled to seek opportunities abroad due to the lack of well-paying jobs in Nepal.

Case Study: Financial Benefits of Working Abroad

A nurse from Biratnagar recently moved to Saudi Arabia. She reported earning Rs. 125,000 per month, with accommodation and food provided by her employer, allowing her to save most of her income. In contrast, she struggled to meet expenses while working as a school nurse in Nepal.

Verification Process and Statistics

As of March 2023, 40,539 nurses in Nepal have obtained 'verification letters' from the Nepal Nursing Council to work abroad. The Nursing Council's Chairman highlighted that many more nurses are expected to seek opportunities abroad in 2023. Currently, there are 82,471 registered nurses in Nepal, and more than 40,000 have sought verification for international employment.

The top destinations for these nurses include:

United States: 23,370 verification letters
Australia: 11,289 verification letters
Dubai: 2,804 verification letters
United Kingdom: 685 verification letters

Unverified Migration

A significant number of nurses migrate without verification from the council. For instance, none of the 800 nurses in Saudi Arabia had received verification. This raises concerns about the impact on Nepal's healthcare system.

Saudi Arabia: A Preferred Destination

Saudi Arabia is particularly attractive to Nepali nurses due to the excellent working conditions, free travel, and the provision of food and accommodation. These nurses often migrate through manpower companies. The initial salary for nurses in Saudi Arabia is around Rs. 200,000, with those holding a PCL and one year of experience earning between Rs. 120,000 to Rs. 160,000.

The migration of Nepali nurses to foreign countries is a growing trend driven by better financial opportunities and working conditions. However, this has significant implications for Nepal's healthcare sector, which may face a shortage of skilled nurses if the trend continues. Addressing this issue requires improving job opportunities and working conditions within Nepal to retain its nursing workforce.

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Factors Influencing Brain Drain among Nepalese Nurses

Affiliation.

1 Department of Nursing, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.
PMID: 29446360

Background Brain drain means migration of technically skilled people from one country to another country. Migration of health workers including nurses are the result of interplay of many push and pull factors. Push factors are those conditions that influence the nurses' decision to leave their own country. Conversely, pull factors are those conditions in a given country that attract nurses, influencing their movement to that country. Objective The objective of this study was to identify push and pull factors of brain drain among the Nepalese nurses. Method Descriptive cross sectional study was done among 228 Nepalese nurses working in five different countries in 2016 by using quota sampling technique. A self administered questionnaire consisting of structured four-point Likert scale was designed to collect information on push and pull factors of brain drain. Descriptive and inferential statistics were computed using SPSS version 16. Result Many of brain drained nurses had ranked very important push factor was personal ambition (72.8%) and very important pull factor was better job and career opportunity (77.2%). Majority of nurses working in Nepal had ranked very important push factor was lack of job and career opportunity (86.0%) and pull factor was better job and career opportunity (85.1%). All push and pull factors were significantly associated with brain drain. Conclusion Most of the Nepalese nurses were forced to go abroad due to personal ambition, followed by low salary, and lack of job and career opportunity. Nurse migration out of Nepal is likely to persist and even increase if underlying factors aren't properly resolved.

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Nepal’s Community Health Worker System

October 21, 2020 By Pat Williams Leave a Comment

By: Bharat Ban, Ashoke Shrestha, Leela Khanal, Henry B. Perry, and Steve Hodgins

52,000 Female Community Health Volunteers serve as part of the Nepali community health workforce. These part-time volunteers primarily support health education, counseling, outreach, and resource distribution. Each volunteer receives counseling, supplies, and other resources from their respective health center on a monthly basis. Their cumulative efforts have contributed to Nepal’s global leadership in maternal and child health outcomes.

Nepali health planners and program managers recognized the geographic and social challenges to providing health services in its population of 29 million people and introduced several cadres of community health workers and volunteers. These have included the full-time, paid Village Health Workers (VHWs) and Maternal Child Health Worker (MCHWs), and part-time voluntary Female Community Health Volunteers (FCHVs). Nepal also has two cadres of health auxiliaries, each with approximately 18 months of pre-service training: Auxiliary Nurse-Midwives (ANMs) and Auxiliary Health Workers (AHWs). This chapter focuses on FCHVs.

Implementation

Each of the most peripheral health facilities in Nepal serves a catchment population typically numbering 5,000–10,000 people. In the past, each had at least one professional health worker, one VHW, one MCHW, and at least nine FCHVs. Now there are no longer MCHW and VHW positions, as they have been replaced by ANMs and AHWs. Nepal has about 52,000 FCHVs. FCHVs are frontline, part-time voluntary service providers who serve as a link between the community and government health services.

Roles/responsibilities

Historically, FCHVs mainly had four functions: health education and counseling, support for outreach services, distribution of health commodities, and provision of sick-child care. However, their roles and responsibilities have evolved and changed over time, and more recently their role in sick-child care has declined. They are engaged in FCHV-related functions on average 7 hours a week.

FCHVs receive 18 days of initial training as well as ongoing in-service training.

Supervision

It used to be the case that most supervision was done by VHWs and MCHWs during their regular outreach activities. However, most FCHVs now visit their respective health facility every month; there, they receive supplies, materials, commodities, and programmatic advice and feedback. This has largely replaced monthly contacts associated with outreach visits. Supervision is now done by AHWs.

Incentives and remuneration

FCHVs are volunteers but are provided training allowances, refresher trainings, an annual clothing allowance, access to microcredit funds, and other incentives. They receive a uniform, a bag and a startup kit of supplies. In addition, FCHVs also receive additional variable incentives from their local municipalities. Working as a FCHV is considered a privilege and although many FCVHs would prefer more generous financial incentives, almost all report being highly motivated to continue in their role even without significant changes in their conditions of service.

Among low-income countries, Nepal has been a global leader in reducing its under-5 mortality rate, pregnancy-related mortality ratio, and fertility rate (reflected in Nepal having succeeded in reaching Millennium Development Goals 4 and 5). There is widespread agreement that Community Health Workers (CHWs) in Nepal, particularly the FCHVs, have played an important role in achieving these important goals.

Read more Health for the People: National Community Health Worker Programs from Afghanistan to Zimbabwe

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Mental health care in Nepal: current situation and challenges for development of a district mental health care plan

Nagendra p luitel.

Research Department, Transcultural Psychosocial Organization (TPO), Kathmandu, Nepal

Mark JD Jordans

Research and Development Department, HealthNet TPO, Lizzy Ansinghstraat 163, 1073 RG, Amsterdam, The Netherlands

Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Box P029 De Crespigny Park, London, SE5 8AF UK

Anup Adhikari

Nawaraj upadhaya, charlotte hanlon.

Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa

Ivan H Komproe

Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands

Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal.

A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records.

Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry of Health and Population (MoHP). Strategies to overcome these challenges included involvement of MoHP in the process, especially by providing psychotropic medicines and appointing a senior level officer to facilitate project activities, and collaboration with National Health Training Centers (NHTC) in training programs.

Conclusions

This study describes many challenges facing mental health care in Nepal. Most of these challenges are not new, yet this study contributes to our understanding of these difficulties by outlining the national and district level factors that have a direct influence on the development of a district level mental health care plan.

Electronic supplementary material

The online version of this article (doi:10.1186/s13031-014-0030-5) contains supplementary material, which is available to authorized users.

Introduction

Globally, mental health problems are a serious public health concern accounting for 7.4% of disability adjusted life years (DALY), and 22.9% of all years lived with disability (YLD) [ 1 ]. It is estimated that four out of five people with mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment and mental health is often one of the lowest health priorities in those settings [ 2 , 3 ]. Studies have documented several adverse consequences of untreated mental illness, including poverty [ 4 ], and premature death [ 5 ]. One of the major barriers to scaling up mental health services in LMIC is the scarcity and unequal distribution of specialist mental health professionals [ 6 ]. For example, the median number of psychiatrists per 100,000 population in LMIC is 0.05 whereas this number is 8.59 in high-income countries [ 7 ]. There is estimated to be a shortage of 1.18 million mental health workers in LMICs alone [ 6 ].

In recent years, a number of initiatives have been taken to reduce the treatment gap for mental health problems [ 8 , 9 ]. Evidence is accumulating that mental health services can be delivered effectively by primary health care workers through community-based programs and task-sharing approaches [ 10 , 11 ]. Changing the role of specialist mental health workers (i.e. psychiatrists and psychologists) from a predominant focus on service delivery to also designing and managing mental health services, building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services, could help in scaling up mental health services in the LMIC [ 8 , 12 ]. The World Health Organization (WHO) launched the mental health Gap Action Programme (mhGAP) for prioritizing mental, neurological and substance use disorders in 2008 [ 3 ]. The aim of mhGAP is to facilitate the delivery of evidence-based interventions by non-specialized health workers in primary health care settings; in addition, mhGAP also advocates scaling up of mental health care through integration of mental health into primary health care [ 3 ].

Recently Nepal emerged from a decade-long conflict which claimed the lives of more than 16,000, while many more were subjected to torture, intimidation, extortion, and abduction. Nepal had the highest number of forced “disappearances” in the world in 2003 [ 13 ]. The conflict also had an impact on the health system of Nepal. During the period of conflict, health staffs were intimidated and tortured by both the Government forces and insurgents. Vehicles carrying medicine and equipment were stopped so delivery of essential supplies was disrupted [ 14 ], which impeded efforts to strengthen the health system and to provide quality health services [ 15 ]. Despite the deterioration caused by the conflict, Nepal has made significant progress over the last few years, in terms of improved health status and living standards of the population. The National Health Policy of Nepal, 1991, emphasized the importance of decentralizing the primary health care system to the rural population and providing services in an integrated manner - from the tertiary to sub-health post level – in order to bring about health improvements [ 16 ]. Community participation is ensured at all levels of health care through the activities of Female Community Health Volunteers (FCHV). In Nepal’s health care system, Sub Health Posts (SHPs) are the first institutional contact point for basic health services. Altogether, there are 3,129 SHPs in the country which provide essential health care packages and also monitor the activities of FCHVs and other community level health care activities. Health Posts (HP) are the next tier of the health care system and they offer the same package of essential health care services as SHPs, with the additional service of birthing centers. Health Posts also bear responsibility for monitoring the SHPs activities. Altogether there are 676 HPs in the country. SHPs and HPs are not staffed by medical doctors but instead are staffed by Health Assistants (HA), Community Medical Assistants (CMA) and Auxiliary Health Workers (AHW), are responsible for out-patient department (OPD) and emergency management in the HPs and SHPs. In addition, the Auxiliary Nurse Mid-wife (ANM), Village Health Workers (VHW) and Maternal and Child Health Workers (MCHW) are responsible for conducting outreach clinics, immunizations, and maternal and child health, especially antenatal and postnatal care. The third tier of health care comprises the Primary Health Care Centers (PHCC), are an upper-level health care facility established in each electoral area, as a first referral point. The major services delivered within PHCCs are general medical care (including mental health services); family planning, maternal and child health, basic laboratory investigations and provision of the basic health care services that are available in HPs and SHPs. PHCC’s are staffed by medical doctors. The district hospital is the highest level health institution within a district. The District Public Health Office (DPHO) or District Health Office (DHO) is responsible for coordinating health care activities in a particular district area.

Recently, a consortium of research institutions and Ministries of Health in five countries in Asia and Africa (India, Nepal, South Africa, Ethiopia and Uganda), with partners in the UK and the World Health Organization (WHO) established the PRogramme for Improving Mental health carE (PRIME) to study the implementation and scaling up of treatment programs for priority mental disorders in primary and maternal health care contexts [ 17 ]. As part of the formative work of PRIME, we conducted a situation analysis to systematically analyze and describe the current gaps in mental health care in Nepal and inform the development of a district level mental health care plan (MHCP). Some of the district level data (PRIME cross country paper) has been published elsewhere [ 18 ]; this paper presents in depth data regarding the current mental health situation in Nepal and describes how the national context and district situation are influencing the development of the district level mental health care plan. The results have been interpreted in line with the World Health Organization recommendations for integrating mental health into the primary health care setting [ 19 , 20 ].

Nepal, a landlocked country situated between India and China, is the poorest country in South Asia. The United Nations ranks Nepal 157 th out of the world’s 186 countries on the Human Development Index (HDI) with 69.1 years life expectancy at birth [ 21 ]. The total population of the country is approximately 28.5 million with the majority (86%) of the total population living in rural areas. Nepal experienced ten years of violent insurgency from 1996 to 2006, initiated by the Communist Party of Nepal Maoist (CPN-M) this was in response to the party’s dissatisfaction regarding gender and caste inequality, and low quality governance. The war formally ended in November 2006 with a comprehensive peace agreement between an alliance of political parties and the Maoists. In 2008, constituent assembly elections were held with the purpose of drafting a new constitution within the following two years. However, after four years, no constitution had been written and consequently the constituent assembly was dissolved in 2012. After a year of political deadlock, a new interim government was formed which successfully completed the election of a second constituent assembly in November, 2013 and handed over power to the newly elected representatives.

A baseline situation analysis was conducted in the five PRIME study sites (Nepal, India, Ethiopia, Uganda and South Africa), to describe the factors relevant to the development and implementation of a district-level mental health care plan [ 18 ]. This study used the situation analysis tool developed by the PRIME consortium ( http://www.prime.uct.ac.za/images/prime/PRIME_Final_Situational_analysis_Tool.pdf ) to collect baseline information relevant to developing a plan to implement and scale up mental health care in Nepal. Details of the development of the situation analysis tool have been reported but the essential components will be outlined in brief [ 18 ]. The situation analysis tool emphasizes those factors which were identified by previous reports, as being important for successful integration of mental health into primary health care [ 22 ] and those that were required for implementation of the WHO’s mhGAP-IG [ 23 ] in the PHC setting. The instrument comprises six sections: Section 1 has 39 items which cover population, economic, health, and social indicators. Section 2 has 15 items including areas such as political support, budget, policy, plan, legislation, benefits and human resources for mental health care. Section 3 focuses on mental health treatment coverage in a district and consists of 19 items related to prevalence of MNS disorders, number of people receiving care and estimated treatment coverage. Section 4, with 62 items, explores district level information about general health services and human resources, mental health care delivered in primary care and health systems structures to support mental health care in PHC. Section 5 has 17 items to document community level information in a district such as; socio-cultural aspects, non-health sector organizations and awareness-raising activities. Section 6 has 4 items related to; health information reporting, monitoring and evaluation systems in a district. The national level data included within the situation analysis tool is initially used to inform the PRIME program being implemented in a single district, and later for discussions regarding the scale-up of services beyond the initial district.

Process and analysis

The study was conducted between October and December 2011 by the Transcultural Psychosocial Organization (TPO Nepal) ( http://www.tponepal.org ). We relied mainly on information available in the public domain such as scientific publications, project documents/reports, media reports and hospital records, which was augmented by discussions with district and national level key stakeholders such as government officers, psychiatrists, hospital administration, and other service providers including NGO staff. For example, we reviewed annual reports published by the Department of Health Services (DHO), and District Public Health Office (DPHO), Demographic and Health Survey reports [ 24 ], the WHO AIMS report for Nepal [ 25 ], and publications from NGOs active in the area. All collected documents and reports explaining the mental health situation or services were reviewed. Information collected from these sources was cross-checked manually to examine the completeness and consistency of the data. Community-level information collected through secondary sources was verified from FCHVs, members of mothers groups, NGO staff and traditional healers. Sources of information, contributing to the situation analysis were documented, together with the date of data collection, allowing the document to be updated when new information was available. When discrepancies between data sources were noted these were cross-checked by the project coordinator, where possible. Information collection from different sources was reviewed and summarized in six broad themes following WHO’s AIMS tool, in order to allow comparison. These themes were policy and infrastructure; mental health services; human resources, mental health in primary health care; public education and links with other sectors; and monitoring and supervision.

The results of the situation analysis have been presented in Table 1 .

Mapping of results from situation analysis


	• National mental health policy developed in 1997.	• Lack of implementation of the policy framework into practice
	• Policy proposes establishing a separate mental health division in the MoHP
		• Lack of endorsement of mental health legislation
	• Policy aims to provide mental health services to all the population by 2000	• No mental health division in the MoHP or Department of Health Services (DoHS)
	• Mental health legislation has been drafted
	• Mental health legislation has been drafted	• Absence of a long-term mental health strategy and program
	• Mental health is also included under Disability Act and ensures disability benefits to people with severe mental illness	• Absence of a long-term mental health strategy and program
		• No sufficient budget allocation on mental health
	• Minimal health budget is allocated for mental health	• No sufficient budget allocation on mental health
	• Mental health services available in the country are mostly institution based	• Lack of holistic treatment approach (community care to specialized care) for the treatment of mental health problems
	• Out of 75 districts, only 7 district hospitals provide mental health services
		• Lack of integration of mental health services to other non-health sectors such as education, social welfare, and sports
	• Mental health services are limited to psychotropic medication
		• Lack of separate hospital for providing mental health services to children and elderly people
	• About 450 mental health beds i.e. 1.5 per 100,000 population (both government and private hospitals) in the country
		• Lack of training and involvement of community volunteers (e.g. FCHVs and traditional healers) in identification and referral of people with mental illness
	• Traditional healers or/and religious leaders are a primary source of mental health treatment in the community
	• NGOs provide community based mental health services to the specific population; mostly these services are in isolation with government services
	• No systematic information available about the services of mental health in the PHCs	• Lack of standardized mental health training manual for PHC workers
	• Mental health services are available in few districts where community mental health services are introduced by both government and NGOs
		• Lack of basic psychotropic medicines in the free drug list
		• Lack of formal referral mechanism from primary to secondary/tertiary care or vice versa
		• Lack of mental health supervision mechanism in the existing supervision system
		• Lack of referral system from primary to tertiary care or vice versa
	• Number of PHC staff trained on mental health by NGOs and government in the country: General Doctors 156 (including doctors from district hospital); Health Assistants/Auxiliary Health Workers (AHWs)/Staff nurse 672; Nurse/auxiliary nurse mid wife 39
	• Only few (i.e. phenobarbitone and amitryptyline) psychotropic medicines available in the PHCC and HP. No psychotropic medicine available in the SHP
	• Mental health services are coordinated by different institutions in the center e.g. mental hospital, management division.	• Lack of designated person in the MoHP to coordinate mental health activities
		• Lack of specific strategy for developing human resources in mental health
	• Limited human resource on mental health: 60 psychiatrists 60 (an estimated 25% are reported to be out of the country); 25 psychiatrist nurses; 16 clinical psychologists; 400–500 para-professional counselors (trained by NGOs); 867 general doctors/PHC workers who have received short mental health training
		• Lack of mental health component in the existing curriculum of all cadres of PHC workers
		• No fulfillment of vacant position in the PHC for long time.
	• Most of the psychiatrists, psychiatrists nurse and psychologists are working in private sector and in big cities
		• High staff turnover and frequent transfer in another places
	• Community health volunteers are not trained on mental health issue
	• No mental health education carried out; hence, low/no public awareness on mental health among the general population	• Lack of mass sensitization program on mental health and psychosocial issues in the community
		• Lack of coordination and linkage with other non health sectors such as education and social welfare
	• Mental health highly stigmatized in the community
	• Psychosocial and mental health services integrated in the hospital based one-stop crisis management center focusing for victims of gender based violence
		• Lack of involvement of key community actors such as teachers, and youth clubs for identification and referral
	• Psychosocial and mental health incorporated in the care plan of children affected by HIV/AIDS
	• Mental illnesses is included under disability
	• Establishment of National Mental Health Network (NMHN) to advocate for mental issues with concerned stakeholders
	• Establishment of two organizations led by people with mental health and psychosocial disability
	• A morbidity form is available for outpatient clinics, from PHC level	• Lack of involvement of mental health specialists (psychiatrist and psychologist) in the supervision of the PHC workers
	• Current HMIS system includes seven mental health indicators (such as Depression, Psychosis, Anxiety (coded as Neurosis), Mental Retardation, Conversion Disorder (Hysteria), Alcoholism and Epilepsy) in the PHC/district level and 47 mental health problems and 13 self-harm related indicators in hospitals
		• Lack of nationally representative epidemiological data on mental health
		• Lack of data use culture at the Health Facility level
	• The only national level mental hospital reports comprehensive data on mental health. Besides the above data, it also provides data on bed occupancy rate, mental health budget release and expenditure and leading causes of morbidity.
	• No separate monitoring and supervision system exists for mental health care
	• Small scale studies have been conducted with specific population to identify prevalence of mental health problems

Policy and legislative framework

A mental health policy for Nepal was developed by the government in 1997 with the commitment of providing basic mental health services to the entire population by integrating mental health care into the existing health care system. The policy framework however, is yet to be implemented; as a result mental health services are essentially limited to a few hospitals, located in the larger cities. The mental health policy proposes several strategies to develop human resources for mental health services and ensure basic human rights of people with mental illness. The mental health legislation which ensures the human rights of people with mental illness was drafted in 2006, but its endorsement by the government is still pending. No clear data were available on the budget amount allocated to mental health and how this money is being spent, because the expenditure occurs in several different ministries including the Ministry of Health and Population and the Ministry of Education. Available data however, indicates that the budget allocated to mental health remains very small, i.e. latest available data reports that less than one percent of the total health budget is spent in mental health [ 26 ] and that a substantial proportion of that budget goes to hospital-based services.

Mental health services

Specialist mental health services were found to be limited to Zonal- or District hospitals. Across the whole country, there are estimated to be around 440 in-patient beds for people with mental illness (combining both governmental, 112 and private hospital facilities, 327); which amounts to 1.5 beds per 100,000 population. No separate in-patient service is available for children with mental illness in Nepal. Due to the geographical circumstances and lack of reliable transportation, Kathmandu (the capital city) or adjoining Indian cities were often the only options available for people with mental illness living in remote districts. In the public sector, counseling or psychotherapeutic services were found to be difficult to access due to the limited number of clinical psychologists. General counseling services are being provided by trained para-professional counselors employed by NGOs; however, such services tend to be limited to specific population groups such as; people affected by conflict, survivors of human trafficking, victims of domestic and gender based violence, and refugees. No systematic data was available regarding the treatment of mental health problems by traditional or religious healers; however, traditional and religious healers are known to be the primary sources of treatment for (mental) health problems in the community [ 27 , 28 ].

Mental health in primary health care

Mental health services are supposed to be included among the basic health services expected to be delivered in PHC; however, there is limited data indicating delivery of mental health services in the PHC setting in practice. The Management Division, part of the Department of Health Services (DOH), mental hospital and some non-governmental organizations (NGOs) have taken the initiative to train PHC workers in a few districts. The lack of refresher training and non-availability of essential psychotropic medicines, however, has meant that despite the training provided there continues to be a lack of availability of mental health services on a regular basis. Two psychotropic medications, phenobarbitone and amitryptyline, were found to be available in the primary health care centers (PHCC) and, more erratically, at the Health Post (HP) level, but no psychotropic medicine was available at the Sub-Health Post (SHP) level. No counseling or psychotherapeutic services were available through the primary health care system. Due to the lack of clear referral mechanisms from primary to tertiary care, people with mental illness were not being identified and treated effectively, even in the health facilities where there were trained health workers. No standardized training manuals, screening tools or guidelines were available, particularly for the training of PHC workers in detection, diagnosis and treatment of common and severe mental disorders.

Human resources

The number of mental health specialists was found to be limited and concentrated in large urban areas. An estimated 25% of Nepali psychiatrists (N = 60) are working outside of the country. Data on the number of PHC workers that have received mental health training is incomplete. Available data indicate that around 900 PHC workers, mostly from PHCC level (156 district hospital/ PHC doctors; 672 Health Assistants/Auxiliary Health Workers/Staff Nurse; and 39 ANMs) have received such training. Due to the lack of timely supervision, refresher training and availability of psychotropic medications, most trained PHC workers are not delivering any mental health support services. Female community health volunteers (FCHVs), who are the first contact point of the current public health services, have not received mental health training.

Public education and link with other services

Mental health problems are highly stigmatized in the community. No mental health awareness programs have been carried out in the public health system. Some NGOs have taken the initiative to run community awareness programs; nevertheless, these programs were targeted to specific populations with limited resources. Due to the lack of a coordinating body in the Ministry of Health, NGO services are implemented in isolation from the public health system. Recently, the Ministry of Health and Population has established ‘one-stop’ crisis centers in some districts of Nepal to provide a comprehensive approach to people suffering from domestic and gender-based violence. Mental health care is a component of this service, but limited to basic psychosocial counseling services. The Ministry of Women, Children and Social Welfare has recently launched a National Minimum Standard (NMS) to ensure comprehensive care and support for survivors of human trafficking and victims of domestic and gender based violence, where psychosocial and mental health services are included as cross-cutting themes [ 29 ]. Stigma and discrimination were found to be one of the major barriers for seeking mental health care in the community. Two national-level user organizations have been established in the recent past to advocate for mental health services and the human rights of people with mental illness. A network of most of the organizations working in the mental health and psychosocial fields has also been established for policy advocacy ( http://mhnetworknepal.org/ ).

Monitoring and research

Mental health indicators have been included in the health management information system (HMIS) from the sub-health post level upwards; although mental health services are not available in either the health post (HP) or sub-health post (SHP). The process of data collection for general health indicators begins at the community level. The Female Community Health Volunteers (FCHVs) use a pictorial register to document health services provided to the community. As these lay health workers are not trained in mental health issues, to date there has not been reporting of any data on mental health. At the PHC and district level either the senior Health Assistant or a medical doctor see the mental health patients and keep records in the out-patient department (OPD) register. Seven different mental disorders, including Depression, Psychosis, Anxiety (coded as Neurosis), Intellectual Disability (coded as Mental Retardation), Conversion Disorder (Hysteria), Alcohol Use Disorder (Alcoholism) and Epilepsy are recorded in the OPD register and reported to the District Health Data Bank located at the District Public Health Office. The data is then reported to a central HMIS section through a HMIS web-portal. Mental health inpatient hospitals and other mental health wards, within the national, regional and zonal hospitals report mental health information to the national HMIS. The annual reports (2008/09, 2009/10 and 2010/11) published by Department of Health Services (DoHS) report data on 47 different mental health problems and 13 items related to self-harm categorized as per ICD-10 definitions. Similar to other health indicators, the quality and accuracy of mental health data collected through HMIS is questioned in regional and national reviews. There are delays in HMIS reporting, sometimes there is under reporting and private health facilities do not regularly report to HMIS.

No national level epidemiological studies have been conducted; therefore no estimates of the national prevalence of mental health problems are available. A few small-scale studies have been conducted mainly by NGOs to identify the prevalence of mental health problems within specific population groups. There is no information regarding the treatment gaps for mental health care.

Overall situation

This situation analysis demonstrates the scarcity of population-wide mental health services in Nepal. Services are restricted to a few specialists operating mainly in private and/or urban settings. Policies regarding the integration of mental health into primary health care are available; however, these have not been operationalized or implemented. Despite many potential strengths, including the existence of mental health indicators integrated within the national HMIS system, the initiatives of several NGOs to promote community mental health, and the active role of user groups on the advocacy front, the situation of the mental health system is still dire in Nepal. No nationally representative data regarding the prevalence of mental health problems in Nepal are available; however, the studies that have been carried out, show that the prevalence of mental disorders in Nepal does not appear to be different from global prevalence [ 30 - 34 ]. Lack of financial resources and low mental health literacy, in particular misconceptions about mental health problems and stigma associated with mental health problems, contribute to delay or obstruct access to treatment for individuals. In addition, poverty, conflict, displacement and discrimination based on gender and caste/ethnicity, unemployment, and (labor) migration are found to be key risk factors for poor mental health in Nepal [ 30 , 35 ].

Improvements

Despite this bleak mental health situation, Nepal has made significant improvements in recent years in comparison to a situation analysis conducted by WHO (WHOAIMS) in 2006 [ 25 ]. For example; the total number of psychiatrists has increased considerably. The number of mental health beds per 100,000 population was less than 1 (0.8) [ 25 ]; now it has been increased to 1.5 per 100,000 population. The involvement of user groups in mental health care, prevention and advocacy have become more established and two national level organizations led by service users have been instituted. Community based mental health programs have been initiated in a few districts by both the government and NGOs [ 36 , 37 ]. In recent years, some initiatives have been taken to include mental health in national health priorities. For example, mental health has been included in the second health sector support program (NHSSP-II); ‘one stop’ crisis centers have been established, and psychosocial and mental health has been included in national minimum standards and standard operating procedures for the care and protection of trafficking survivors [ 29 ]. Additionally mental health and psychosocial components in the protection and care for children affected by HIV/AIDS [ 38 ]; and the provision of psychotropic medicines in the revised drug lists are key policy level initiatives in mental health and psychosocial care.

Challenges in developing the district level mental health care plan

In spite of a significant improvement in the situation of mental health care in the last few years; there remain numerous challenges that have impeded the development of the district level mental care plan. Here, we have highlighted key challenges that were identified in the situation analysis and how these challenges were addressed while developing the district mental health plan. First, like other LMIC, there are scarce mental health human resources for providing mental health services in Nepal [ 39 ]. Integration of mental health services in the PHC is presented as a strategy to reduce treatment gaps, even though this approach will add more responsibilities to the already overburdened health workers [ 40 ]. Rather than providing training to a specific person in the PHC regarding mental health care; we have proposed to train all the PHC workers, to minimize the extra burden of work for one particular person. Secondly, the lack of psychotropic medicines in the PHC has obstructed the availability of mental health services. A memorandum of understanding (MOU) has been signed with the Ministry of Health and Population (MOHP) stating that the essential psychotropic drugs will be supplied through Primary Health Care Revitalization Division (PHC-RD) by allocating the financial budget to the District Public Heath Office (DPHO). Thirdly, a monthly case conference by a psychiatrist from the district hospital has been put in place, to bridge the gap of the current lack of mental health supervision in the existing health care system. Fourthly, considering the current work burden of the PHC workers, the concept of community counselors (i.e. one psychosocial counselor for a certain number of PHCs) has been integrated into the district level MHCP to relieve PHC workers from time-intensive psychotherapeutic services. Fifthly, collaboration with the National Health Training Center (NHTC) has been initiated to conduct training and accredit training certificates for PHC workers, and to ensure that the training manual is in line with government standards. Sixthly, despite the Nepalese government’s commitment to establish a separate division, to coordinate mental health activities as stated in policy, it has not yet been operationalised. The MOHP has agreed to assign a senior level officer in the MOHP to facilitate coordination of the project activities at the national level; this has also been included in the MOU. Seventhly, a Community Informant Detection Tool (CIDT) has been developed to facilitate community detection of mental health problems and increase referral to the PHCs [ 41 ]. Female Community Health Volunteers (FCHVs) and mothers group leaders, who are often the first point of contact in their community, have been trained in the use of CIDT. Finally, a referral system has been developed with district hospitals for severe cases in need of specialized care.

Opportunities for developing district mental health care plan

Globally, several initiatives have taken place to reduce the treatment gap for mental health. Many international and national initiatives and other contextual factors have facilitated the development of district level mental health care plan under PRIME. Firstly, the WHO Mental Health Gap Action Program (mhGAP), has been developed to assist in the scaling-up of mental health services in LMIC [ 3 ], and this has been adopted in the Nepalese context to develop the district level mental health care plan. Secondly, the mental health policy (1997) has emphasized the integration of mental health into the PHC by mobilizing existing health workers; and the recent study among the PHC workers has found a positive response and willingness of PHC workers to engage in the process of task shifting [ 40 ]. Thirdly, the Nepal health sector support program II (2010–2015) has included mental health components, with the aim of developing a model that could allow integration of mental health into primary health care [ 42 ]. Fourthly, initiatives to provide mental health services to specific populations have already been started through the establishment of ‘one stop’ crisis centers in some districts [ 43 ]. Fifthly, the Inter Agency Standing Committee (IASC) guidelines on mental health and psychosocial support; which emphasized the value of integrated mental health services, has been translated and pilot-tested in Nepal [ 44 ] and Nepal has also signed international conventions including Universal Declaration of Human Rights (UDHR), International Convention of Economic, Social and Cultural Rights (INCESCR) and the Convention on Rights of People with Disabilities (CRPD). Sixthly, a greater need for mental health services in the post-conflict situation has been indicated in a study conducted immediately after the peace agreement between the Government of Nepal and the Maoists which identified a high prevalence of mental health problems in Chitwan and recommended the urgent need for mental health care [ 30 ]. Finally, as in other post conflict settings, where post-conflict system restructuring has lead to opportunities for improving mental health care [ 45 , 46 ]; currently several policy developments initiatives (e.g. Health Act, Mental Health Act, Nepal Health Sector Support Program III) are occurring in post conflict Nepal that can be capitalized upon. The current study can contribute to this policy development process, by identifying the areas for improvement, as well as providing some proof of concept of district level mental health care.

Implications

Recommendations from this situation analysis focus on addressing the identified gaps, particularly for the integration of mental health into the existing health care system. Firstly, it would be easier to coordinate mental health activities and issues with the government, at the central and district level, if a separate mental health unit were to be established in the MoHP. Secondly, considering the risk of overburdening the existing health workers and lack of mental health specialists in many of the districts, we recommend the development of a mid-level mental health and psychosocial cadre within the primary health care system. The concept of mid level mental health professionals has been put into practice in other LMICs such as Uganda [ 47 ] and Liberia [ 48 ]. Thirdly, as no mental health services are currently available in many of the districts, an efficient referral mechanism should be established to provide specialist mental health services to people with severe mental disorders. Fourthly, non-governmental organizations (NGOs) can play an important role in developing and delivering models for more innovative services; supporting government initiatives and building capacity [ 49 - 51 ]. In Nepal, NGOs have played an important role, especially in providing mental health services for disaster-struck populations, developing community-based mental health care, creating awareness on mental health issues and advocacy [ 52 ]. NGOs therefore may need to be involved in the development and implementation of sustainable mental health services. The community at large has a significant role in mental health advocacy and service delivery. Comparisons can be drawn between Nepal and Cambodia as both are war torn countries. The experience in Cambodia of establishing mental health systems highlights the importance of cultural sensitivity and mobilization of local resources, where mental health services were able to be delivered by traditional healers and key community leaders, along with basic mental health care, integrated into primary health care. [ 53 ]. Other studies also echo the importance of the involvement of community members as they are culturally sensitive to the context, culture, beliefs and values [ 54 ]. Service users and community members may therefore need to be involved in development and implementation of sustainable mental health services.

Our study has some limitations. The most important limitation is that the PRIME situation analysis focuses on readily measurable health system indicators, and data was collected mainly from secondary sources i.e. published data, grey literature, and organization reports. Secondly, this report does not provide an in-depth understanding of attitudinal factors, for example, the acceptability of task-sharing mental health care by health care workers and community members. This issue was addressed in the qualitative formative research, conducted by the PRIME study and has been published elsewhere [ 40 ]. Nonetheless, the PRIME situation analysis tool yields data that has value for the planning of integrated mental health services, as well as evaluating the impact of implementing these plans. Further, the core focus of the PRIME situation analysis tool was to collect detailed district level information to map the major gaps to be addressed, by the district mental health care plan. In doing so, only limited national level information was assessed, which is something that should be addressed when using the tool for national level situation analyses.

The strengths of the PRIME situation analyses tool were twofold: (a) it structured the process of development of services to respond to existing gaps, and (b) it engaged local stakeholders by using local data and context as the starting point for the MHCP development.

This study has underlined many of the known challenges in mental health care in Nepal. However, the results of this study were very helpful for the development of the district level mental health care plan, especially regarding how national context and the district situation can influence the district care plan and what is realistic and feasible given the current lack of capacity at the district level. The key challenges which had influenced the development of the district MHCP included; overburdened health workers, the lack of psychotropic medicines in the PHC especially in the HP and SHP, the lack of mental health supervision in the existing system of care, the lack of a coordinating body in the MoHP, and stigma and discrimination associated with mental illness in the community. Many strategies were adopted to overcome these challenges which included the involvement of MoHP in the program, especially providing psychotropic medicines and appointing a senior level officer to facilitate project activities and collaboration with NHTC. In addition, the lasting effect of the decade-long conflict still exerts an impact on the mental health and psychosocial well-being of people [ 30 , 55 ]. The provision of separate mid level mental health and psychosocial cadre at PHC may need to be considered to meet the level of need. Nepal has seen clear progress in strengthening the mental health care system in the past decade or so, however, major improvements are still required. The weak governance system explains many of the remaining gaps, but also offers opportunities for re-structuring mental health services in post-conflict Nepal.

Acknowledgements

This document is an output from the PRIME Research Programme Consortium, funded by UK aid from the UK Government, however the views expressed do not necessarily reflect the UK Government’s official policies. We want to thank Ms. Sirjana Pandey, Mr. Laxminath Koirala and Ms. Prasansa Subba for their involvement in the study.

This manuscript is part of the 'Filling the Void: Health systems in fragile and conflict affected states' thematic series.

Abbreviations

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

NPL was responsible for study design, was responsible for implementation of the study, and drafting the manuscript; MJ was responsible for study design, contributed to drafting manuscript; AA responsible for data collection and reviewing the manuscript; NU responsible for reviewing the manuscript; CH was involved in the development of the study design, responsible for developing data collection tools, contributed to drafting manuscript; CL was involved in the study design, and contributed to drafting the manuscript; IHK contributed to drafting manuscript. All authors read and approved the final manuscript.

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मेरो देश नेपाल बारे निबन्ध | Essay on my country nepal in nepali

मेरो देश नेपाल बारे निबन्ध | essay on my country nepal in nepali , मेरो देश नेपाल बारे निबन्ध (१५० शब्दहरु ) mero desh essay in nepali language, मेरो देश को बारेमा निबन्ध 200 शब्दमा essay on my country in nepali in 200, मेरो देश नेपाल बारे निबन्ध (२५० शब्दहरु ) mero desh nepal essay in nepali, मेरो देश को बारेमा निबन्ध 300 शब्दमा essay on my country in nepali in 300, मेरो देश नेपाल बारे निबन्ध ( ५०० शब्दहरु) essay on my country nepal in nepali in 500 words, recommended posts, post a comment.

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मेरो देश नेपाल बारे निबन्ध | Mero Desh Nepal bare Nibandha |

Essay 1

मेरो देश नेपाल बारे निबन्ध (१५० शब्दहरु )

नेपाल दक्षिण एसियामा सुन्दर जग्गाजस्तो देश हो यसको राजधानी शहर काठमाडौं हो। नेपाल भारत र चीन ले घेरिएको छ। नेपालमा एक राजा हुन्थ्यो तर अब राष्ट्रपति छ। नेपाललाई तराई, पहाड र हिमाल गरि तीन भागमा बाँडिएको छ।

नेपाल सगरमाथा, सुन्दरता र पशुपति मन्दिरको लागि प्रसिद्ध छ जुन हिन्दुहरूको लागि हो। माउन्ट एभरेष्ट विश्वको सबै भन्दा अग्लो पहाड हो जहाँ धेरै पर्यटकहरू आउँछन्। यी बाहेक, हामीले भ्रमण गर्नुपर्ने नेपालका तीन स्थानहरू लुम्बानी, चितवन र पोखरा पनि हुन।

लुम्बनी त्यो ठाउँ हो जहाँ भगवान बुद्ध जन्म भएको । चितवन जंगल सफारीको लागि प्रसिद्ध छ। पोखरा पर्यटकका लागी हेर्न धेरै सुन्दर ठाउ हो। गत बर्ष नेपालको भ्रमण गरियो र मलाई पानी पुरी र नेपालको मोमो मनपर्‍यो।

नेपालको राष्ट्रिय चाड़हरू दशै र तिहार हुन् र राष्ट्रिय जनावर गाई, राष्ट्रिय फूल लालिगुरास र राष्ट्रिय पक्षी डाफे हुन। नेपालमा धेरै अवसरहरू छन्। म चाहन्छु कि नेपालमा सबैको रोजगारी होस र नेपाल पर्यटकका लागि स्वच्छ र शान्तिमय रहनको लागि कुनै झगडा बिना नै रहोस्।

अन्तमा मलाई नेपाली भएकोमा गर्व छ र नेपालको संस्कृति मन पराउँछु। जब म ठूलो हुन्छु म नेपालका गरिब र दरिद्र मानिसहरूलाई सहयोग गर्न चाहन्छु।

मेरो देश को बारेमा निबन्ध 200 शब्दमा

म नेपाली हुँ । मेरो देश नेपाल हो । मलाई मेरो देश नेपालको धेरै माया लाग्छ । मेरो देश नेपाल एशिया महादेशमा रहेको सानो अनि विश्वकै एउटा अत्यन्त सुन्दर राष्ट्र हो । यहाँको हावापानी र प्राकृतिक वातावरण असाध्य रमणिय छ । नेपालमा धेरै हिमाल, पहाड र नदीनालाहरु छन । संसारको सबैभन्दा अग्लो हिमाल सगरमाथा पनि यही छ । हिमाल सगरमाथा पनि नेपालमै छ । यहाँ वन, जंगल, लेक, बेसी र रमणिय हरिया फाटहरू पनि छन् ।

मेरो देश नेपालमा धेरै जाति, धर्म, भाषा तथा विभिन्न रहनसहन भएका मानिसहरू बस्दछन् । यहाँ किसिम किसिमका कला, संस्कृति, चाडपर्व, परम्परा तथा रीतिरीवाजहरू छन । त्यसैले, मेरो देश नेपाललाई थरीथरीका फूलहरूको एउटा सुन्दर माला पनि भनिन्छ । मेरो देश नेपालको राष्ट्रिय भाषा नेपाली भाषा हो । यहाँ अन्य सयवटा भन्दा बढी भाषाहरू बोलिन्छ तर सबै नेपालीहरूले नेपाली भाषा बोल्दछन । नेपालमा बस्ने मानिसलाई नेपाली भनिन्छ ।

मेरो देश नेपालमा विभिन्न किसिमका जनावर, चराचुरुङ्गी तथा किराहरु पाइन्छ । यहाँ असाध्यै राम्रो फूलहरू पनि पाइन्छ ।

हामीले आफ्नो देशलाई माया गर्छौ तथा म आफुलाइ गर्वाबित ठन्छु किनकी यो देश नेपाल हाम्रो जन्म भुमि हो । हामी सबैले हाम्रो देश नेपाललाई सम्मान गर्नु पर्छ। नेपाल छन त हामी छौ।

Essay 3

मेरो देश नेपाल बारे निबन्ध (२५० शब्दहरु )

मेरो देश नेपाल दुई देशहरु द्वारा घेरिएको छ। चीन उतरपट्टि अवस्थित छ र पश्चिम, पुर्व र दक्षिण भारतले ढाकेको छ। यो उत्तरी गोलार्द्धमा छ। हाम्रो देश तीन भौगोलिक क्षेत्रहरू छन्। हिमालय, पर्वतीय र तराई।हाम्रो देशमा जाडोमा धेरै चिसो र सुख्खा हुन्छ र गर्मीमा आँधीबेहरी,बर्षा र बाढिपहिरो हुनछन् ।यो प्राकृतिक सौन्दर्य र स्रोतहरु मा धनी छ। यसमा कोशी, गण्डकी र कर्णाली जस्ता लामो र चौंडा नदीहरू छन्। हामीसँग रुपा, बेगनास, र रारा जस्ता ठूला तालहरू छन्। हामीसँग हरियो उपत्यका, सुन्दर पानी, झरना आदि छ। यो धार्मिक र ऐतिहासिक सम्पदामा धनी छ। लुम्बिनी, गोरखा, जनकपुर, काठमाडौं प्रख्यात उदाहरणहरू हुन्।

नेपाल अत्यधिक विविध र धनी भूगोल, संस्कृति र धर्महरूको देश हो। हिमाली उत्तरमा विश्वका १४ उच्चतम पहाडहरूमध्ये आठ छन्, सब भन्दा अग्लो, सगरमाथा, अंग्रेजीमा माउन्ट एभरेष्टको रूपमा चिनिन्छ। उर्वर र आर्द्र दक्षिणी क्षेत्र शहरी छ।

यहाँ धेरै जाति र धर्मका मानिस बस्छन्। लगभग सय भाषाहरु बोलिन्छन्। हाम्रो लोकप्रिय खानाहरू दाल भाट, डिन्डो, गुनर्दुक इत्यादि हुन्। दशैं, तिहार, लोसार, आदि सबैभन्दा लोकप्रिय चाडपर्वहरू हुन्।

नेपाल सानो छ तर प्राकृतिक स्रोतसाधनमा धनी छ तर आर्थिक अवस्थाले गर्दा गरीब छ। नेपाल विकासोन्मुख देश हो। चाँडै नै विकास गर्नका लागि आजदेखि हामीले देशको सबै नागरिकता बारे सचेत हुनुपर्दछ। पुरुष र महिला दुबै समान हुन र शिक्षा प्रदान गर्दछ, सरकारले अग्रिम कार्यक्रम ल्याउनु पर्दछ र नागरिक र सरकार दुबैलाई फाइदा पुर्‍याउने बिभिन्न सुविधा प्रदान गरी नागरिकलाई सहयोग गर्नुपर्दछ।

नेपाल एक सुन्दर देश हो। त्यसोभए, हामीले यसलाई विश्वभर प्रकाशित गर्नुपर्नेछ जुन प्रत्यक्ष वा अप्रत्यक्ष रूपमा पर्यटकलाई आकर्षित गर्न मद्दत गर्दछ र हामी आफ्नो आर्थिक अवस्था नियन्त्रण गर्न सक्छौं।सफलता हाम्रा बलहरू विकास गरेर प्राप्त हुन्छ, हाम्रा कमजोरीहरू हटाएर होइन।

मेरो देश को बारेमा निबन्ध 300 शब्दमा

नेपाल ! हाम्रो देश । हाम्रो मातृभूमि ! हाम्रो जन्मस्थान ! हामी नेपाली हुनुमा गौरवान्वित छौं । हामीलाई हाम्रो मातृभूमिको मुकुट विश्वको सर्वोच्च शिखर, पर्यटकहरू र पर्वतारोहीहरूको महा आकर्षण सगरमाथाको गौरव छ । हामीलाई गौरव छ कि प्रकृतिले हाम्रो मातृभूमिलाई पहाड, डाँडा, उपत्यका, बैंसी र मैदानले शृङगारेको छ । विभिन्न प्रकारका उपयोगी रूखहरू, औषधिका जडीबुटीहरू, मोहक फूलहरू, सामान्य र दुर्लभ जनावर र चराचुरुङ्गीहरू युक्त वनजङ्गल हाम्रो देशलाई सुन्दर र पर्यटन केन्द्र बनाउँछन् । प्रकृतिले हाम्रो देशलाई खनिज र ग्लेसियर, ताल, नदी, प्रसवण र झरनाको रूपमा विशाल जलसाधन दिएको छ । यिनीहरूले हाम्रो भूमिलाई संसारको दोस्रो सर्वाधिक जलसाधनमा धनी देश बनाएका छन् ।

हामीलाई गौरव छ कि हाम्रो माटो पवित्र छ । विष्णुप्रिया महादेवी लक्ष्मी यहाँ सीताको रूपमा अवतीर्ण हुनुभयो । यो त्यही पावन भूमि हो जहाँ विष्णुको दसौं अवतार, एसियाको प्रकाश, गौतम बुद्धको जन्म भएको थियो र उनको धर्मको प्रचार अनेक देशहरूमा भएको थियो । यो त्यही पवित्र स्थल हो जहाँ महान् ऋषि बाल्मीकि र व्यासले तपस्या गरेका थिए जहाँ महान् राजा जनकले राज्य गरेका थिए, जहाँ महान् विद्वान् याज्ञवल्क्य र मैत्रेय बस्दथे ।

हामी गौरवान्वित छौं कि हाम्रो देशले वीर सैनिकहरूलाई जन्म दिएको छ जसको नाम र यश संसारमा छ र जसले आफ्नो अद्वितीय वीरताले आफ्नो देशको स्वतन्त्रताको रक्षा गरे । हाम्रा विभिन्न जात, जाति, धर्म, परम्परा र रीतिरिवाजका जनताहरूले अद्वितीय उदाहरण प्रस्तुत गरेका छन् । हामी विश्व शान्तिको पक्षमा छौं । हामीलाई संयुक्त राष्ट्रसङ्घको वडापत्रमा विश्वास छ । हामी विश्वमा शान्ति कायम गर्न सधैं तत्पर रहन्छौं । हाम्रा शान्ति सैनिकहरू अशान्त देशमा शान्ति स्थापना गरिरहेका छन् । हामी “ बाँच र बाँच्नदेऊ " नीतिमा आस्था राख्दछौं । हामी हाम्रा चन्द्र सूर्य भएको राष्ट्रिय झन्डा सधैं आकाशमा फहराउन कृत सङ्कल्पित छौं ।

म आफ्न देशलाई धेरै माया गर्छु र म नेपाली हुनुमा धेरै गर्व महसुस गर्द्छु। हाम्रो देश नेपाल लाई सबैले सम्मान गर्नु पर्छ।

Essay 5

मेरो देश नेपाल बारे निबन्ध ( ५०० शब्दहरु)

मेरो देश नेपाल दक्षिण एशियामा भारत र चीनको बीचमा अवस्थित छ। मेरो देशको कुल क्षेत्र १,४७,१८१ वर्गमीटर छ। यो एक जग्गायुक्त देश हो। नेपाल एउटा सानो देश हो तर त्यहाँ भौगोलिक विविधता छ। यो साधारण सम्पत्ति र संस्कृतिमा धनी छ। हामीलाई थाहा छ कि ब्राजिल पछि नेपाल जलस्रोतमा दोस्रो ठूलो देश हो। मुख्य नदीहरू कोशी, गण्डकी र कर्नाली हुन्। नेपालमा विभिन्न प्रकारका खनिजहरू र जङगलहरू पनि भेटिन्छन्।

हामीलाई हाम्रो मातृभूमिको मुकुट, विश्वको सर्वोच्च शिखर, पर्यटकहरू र पर्वतारोहीहरूको महा आकर्षण सगरमाथाको गौरव छ । हामीलाई गौरव छ कि प्रकृतिले हाम्रो मातृभूमिलाई पहाड, डाँडा, उपत्यका, बेंसी र मैदानले सिंगारेको छ । विभिन्न प्रकारका उपयोगी रुखहरू, औषधीका जडीबुटीहरू, मोहकफूलहरू, सामान्य र दुर्लभ जनावर र चराचुरुङ्गीहरू युक्त वनजंगल हाम्रो देशलाई सुन्दर र पर्यटन केन्द्र बनाउँछन् । प्रकृतिले हाम्रो देशलाई खनिज र ग्लेसियर, ताल, नदी, प्रसवण र झरनाको रुपमा विशाल जलसाधन दिएको छ ।

हामीलाई गौरव छ कि हाम्रो माटो पवित्र छ । विष्णु प्रिया महादेवी लक्ष्मी यहाँ सीताको रुपमा अवतीर्ण हुनुभयो । यो त्यही पावन भूमि हो जहाँ विष्णुको दसौं अवतार, एशियाको प्रकाश, गौतम बुद्धको जन्म भएको थियो र उनको धर्मको प्रचार अनेक देशहरूमा भएको थियो । यो त्यही पवित्र स्थल हो जहाँ महान ऋषि बाल्मीकि र व्यासले तपस्या गरेका थिए जहाँ महान राजा जनकले राज्य गरेका थिए, जहाँ महान विद्वान याज्ञवल्क्य र मैत्रेय बस्तथे ।

राष्ट्रिय गीत "सयौं थुँगा फूलका हामी, एउटै माला नेपाली"

हो र यो देश नेपालको प्रमुख बिन्दु मध्ये एक गौतम बुद्ध लुम्बिनीमा नेपाल मा जन्म भएको थियो र यसको प्राकृतिक सौन्दर्य हो।

धेरैजसो किसानहरू हुन्। तिनीहरूले धान, मकै, गहुँ, कोदो, जौ, आलु आदि उत्पादन गर्दछन् शहरका केही मानिसहरू व्यापारीहरू हुन्। केहि उद्योगीहरु छन् र तिनीहरू धेरै श्रम र शिष्ट छन्।

प्राकृतिक स्रोतहरूमा पुग्नको कारण, पर्यटकहरू तपाईंको देश भ्रमण गर्न मन पराउँछन्। तिनीहरू यहाँ लोपोन्मुख चराहरू र जनावरहरू हेर्न सक्छन्।तिनीहरूले प्राकृतिक सुन्दरता पनि देख्न सक्छन्।त्यसैले पर्यटन हाम्रो सम्भावित उद्योग हो।

नेपालमा बस्ने मानिसहरु बिभिन्न जाति र धर्मका हुन् जसले विभिन्न परम्परा र सांस्कृतिक मूल्यहरु पछ्याउँदछन्। जस्तो कि हामीलाई थाहा छ कि नेपाल एउटा हिन्दू देशको रूपमा चिनिन्छ, अन्य धर्महरू जस्तै बौद्ध, क्रिश्चियन, किराट, इस्लाम, इत्यादि द्वारा। तिनीहरू विभिन्न चाडहरू मनाउँछन् र उनीहरूको आफ्नै मातृभाषाको भाषा छ। हाम्रो मुख्य खाना दाल भात हो। 80% भन्दा बढि मानिसहरु कृषिमा संलग्न छन्। केवल थोरै व्यक्तिले कारखाना, कार्यालय, व्यवसाय, आदि मा काम गर्छन् काठमाण्डु हाम्रो राजधानी शहर हो जुन मन्दिरको शहरको रूपमा पनि चिनिन्छ।

हामी विश्व शान्तिको पक्षमा छौं । हामीलाई संयुक्त राष्ट्रसंघको बडापत्रमा विश्वास छ । हामी विश्वमा शान्ति कायम गर्न सधै तत्पर रहन्छौं । हाम्रा शान्ति सैनिकहरू अशान्त देशमा शान्ति स्थापना गरिरहेका छन् । हामी “ बाँच र बाँच्नदेऊ " नीतिमा आस्था राख्दछौं । हामी हाम्रा चन्द्र सूर्य भएको राष्ट्रिय झण्डा सधैं आकाशमा फहराउन कृत सङ्कल्पित छौं ।

हाम्रो देश नेपालका मुख्य समस्यामा वनविनास एक मुख्य हो जसले गर्दा बाढी, पहिरो, भूक्षय र परिस्थितिकीय प्रणाली विनास हुन्छ । संसारको सर्वोच्च शिखर सगरमाथा नेपाल र चीन को सीमानामा अवस्थित छ ।

Essay 6

मेरो देश नेपाल

हिमालको सेतो फेटा, पहाडको हरियो भोटा र तराईको पहेँलो कछाड फेरेर बसेको मेरो देश मेरो मुटुको टुक्रा हो । सिन्धुमा हराएको विन्दु जस्तै विश्वको भूमण्डलमा सानो देखिए पनि मेरो देश मेरो प्राकृतिक दृश्यले एकदमै सुन्दर र पवित्र छ । पूर्व मेची र पश्चिममा कालीको रेखा कोरेर उत्तरतर्फ हिमश्रृङ्खलाको प्राकृतिक पर्खाल लगाई स्वयम् प्रकृति नै मेरो देशको रक्षामा खटिएकी छिन् । यस देशको चार किल्लाभित्र प्रकृति रमाउँदै नाचेकी छिन् ।

सूर्यका सुनौलो र सुकुमोल किरणहरु जब हिमाललाई स्पर्श गर्दै आउँछन् । अनि मेरो देशमा उज्यालो देखिन्छ । रहस्यको सखर मेरो देश अनेकता भित्र एकता भएको देश हो विश्वभरिकै प्राकृतिक सौन्दर्यलाई जम्मा पारेर भगवान्ले यसै मुलुकमा खन्याएकी छिन् । “चार जात छतिस वर्णको फूलबारी” का रुपमा रहेको मेरो देशभित्र अनेक जातजाति छन् ।

शेर्पा नाच, गुरुङको रोदी, लिम्बुको धाननाच र नेवारको लाखेनाचले यहाँ अलग–अलग संस्कृति र जातिको परम्परा छन् । तर यहाँ ती प्रत्येक जातजातिरुपी रंगीबिरंगी फूलहरुका बीचबाट विभिन्न संस्कृतिहरुका माझबाट एउटा राम्री सौन्दर्य ज्योतिको प्रस्तुती भएको छ र नेपाली संस्कृतिको जन्म भएको छ । यहाँ बुद्धका भक्तहरु पशुपतिका दर्शनको लागि छट्पटिरहेका र पशुपतिका भक्तहरु गुम्बा दर्शनको लागि यति स्वच्छ भूमिभित्र पशुपतिनाथ र स्वयम्भूले रत्नपार्कको मस्जिदसँग डाह गर्दैनन् । गिरिजाघरको विरुद्ध लडाई गरेका छैनन् । यसरी धार्मिक सहिष्ण्ुताको मूल फुटेको देश हो मेरो देश । हाम्रो देश नेपालमा सबै बिच घनिष्ट सम्बन्ध रहेको छ । यसले हाम्रो देशलाई अरु भन्दा फरक र राम्रो बनाएको छ । सबैका बिचमा हुने सहिष्णुताको भावनाले हाम्रो देशमा एकअर्कालाई हेप्ने, इर्श्या र डाहा गर्ने, धर्म र संस्कृतिमा बेदभाव गर्ने जस्ता काम हुदैनन्।

नेपालमा कलकल बग्ने खोला र छंगछंग गर्ने झरनाको आवाजमा चराचुरुङ्गी चिरबिर स्वरको मिश्रणले एउटा राम्रो ध्वनी निस्किन्छ अनि त्यसबाट नसोचेको आनन्दको प्राप्त हुन्छ । मानिस जब प्रकृतिको यस्तो रमणीय ठाउँमा आफु भएको देख्छ तब उसलाई केही कुराको मोह, स्वार्थ रहदैन ।

यहाँ जब खोलाको पवित्र पानीको स्पर्श हाम्रो जिउसंग हुन्छ तब एक प्रकारको आनन्द महसुस हुन्छ। त्यो आनन्द र त्यस्ता पलहरु हामी विश्वमा कतै पनि भेटाउन सक्दैनौ। त्यसैले त रम्घाको पाखामा भानु उदाउँछन् गोसाइकुण्डको यात्रामा देवकोटा गुनगुनाउँछन्, अर्घौ अर्चले लेखनाथ जन्माउँछ, औँसीका काली रातमा पनि भोसिको टोलमा मोती चम्कन्छन् । प्रकृतिको वातावरणले सिंगारिएका पहाडको स्वच्छ हावा र चिसो पानीले राता राता गाला भएका पहाडीहरु जब मुस्कुराउँछन् अनि त मोनालिसाको सौन्दर्य पनि पानी बन्छ ।

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