Assessing Nepal's health policies and programs from a human rights perspective

Background: The right to health is a fundamental part of human rights. Ensuring right to health is not straightforward; there are several challenges. Factors such as capacity of right holders and duty-bearers and practices of providing and utilizing services among others determine to ensure health rights for the whole population. Objective: The objective of this paper is to analyze whether the health policies and programs follow a human rights-based approach (HRBA) and assess the situation of rights to health among the poor and vulnerable population. Methods: The study assessed domestic instruments against human rights policies and analyzed the implementation status of the policies and programs. An analytical case study method is used by utilizing qualitative and quantitative data. Results: Around 90% medicines are available in the facilities; however, 22% of health worker posts are vacant. Persistence of unequal distribution of health facilities, high out-of-pocket payment, and cultural and language barriers does not ensure accessibility of health services. Acceptability of health-care services in terms of utilization rate and client satisfaction is improved after introduction of new policy. Nepal has made significant progress in improving maternal mortality ratio, infant/child mortality, immunization rates, and life expectancy at birth. Conclusions: Although a progressive realization of the right to health is being achieved, more efforts are still needed to follow HRBA so as to achieve quality and equity in health-care services.

Cerebellar Mutism After Pineal Tumour Excision: A Case Report.

Cerebellar mutism syndrome (CMS) was first described by Rekate et al in 1985. This syndrome is a common complication of posterior fossa surgery in children with range of 11-29% and usually manifests as diminished speech, hypotonia, and ataxia. The cause is due to bilateral pertubation of the dentate nuclei and their efferent pathways by edema, perfusional defects, axonal damage or metabolic disturbances. Other rare causes of CMS like acute subdural hematoma of the posterior fossa, head injury, brainstem glioma surgery, meningitis and basilar artery occlusion have also been reported. CMS after supracerebellar resection of the pineal tumor is a very rare with very few cases reported. We report such a case in a 10- year old boy who underwent excision of a pineal tumor through the infratentorial supracerebellar route.