Nepal

Population Mobility and Public Health Risk Mapping - COVID-19 Preparedness and Response Plan in Nepal (2020): Dhangadhi Sub-Metropolitan City

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1. INTRODUCTION

The Coronavirus disease 2019, hereinafter referred to as COVID-19, is caused by SARS CoV-2 Virus and is the third recorded animal-to-animal transmission of a Coronavirus, after Severe Acute Respiratory Syndrome (SARS, 2002), and Middle East Respiratory Syndrome (MERS, 2012). The first COVID-19 case was detected in Hubei Province, China, on 17 November 2019. Since then, the disease has spread throughout the globe to the extent to be declared as a pandemic by the World Health Organization (WHO), on 11 March 2020. As of 4 November 2020, the number of cases stands at 47,059,867, including 1,207,327 deaths worldwide.

In Nepal, the first case of COVID-19 was reported on 23 January 2020. As of 4 November 2020, the total number of confirmed cases in Nepal stands at 179,614 with over 100,000 newly detected cases in five weeks, and 1,004 deaths. Since the detection of the second positive case on 24 March 2020, the Government of Nepal (GoN) has taken several steps to control transmission and mitigate the impact of COVID-19 on the society, including enforcement of nation-wide lockdown, closure of international border, testing of suspected cases, isolation, treatment, contract tracing, and management of quarantine centres.

1.1 POPULATION MOBILITY MAPPING (PMM)

The Population Mobility Mapping was developed through an adaptation of IOM’s Displacement Tracking Matrix (DTM) and has been implemented as part of the response and preparedness plan to several outbreaks, specifically the Ebola Virus Disease (EVD) in West Africa (2014-2016), the Democratic Republic of Congo (2017, 2018-2020),
Burundi, South Sudan and Uganda (2019), as well as the plague outbreak in Madagascar (2018). The aim of PMM is to understand the dynamics of human mobility and identify the most vulnerable, priority locations within and outside the border. The findings enable the Government, communities and various actors to prevent the introduction or to limit the spread of infectious diseases and other public health threats, directly affected by human mobility. The Population Mobility Mapping was selected by the Ministry of Health and Population (MoHP) as part of the national COVID-19 Response and Preparedness Plan.

Specific locations to conduct the PMM activities were selected. The selection was based on three main criteria; a) existing knowledge on health risks and general epidemiological information, b) population mobility dynamics based on local available information, and c) accessibility and resources availability. Based on this, nine (9) Municipalities were identified in three (3) Provinces in Nepal:

I. Sudurpashchim Province

1. Dhangadhi Sub-Metropolitan City (Kailali District)
2. Bheemdatta Municipality (Kanchanpur District)
3. Dasharathchanda Municipality (Baitadi District)

II. Lumbini Province

4. Nepalgunj Sub-Metropolitan City (Banke District)
5. Krishnanagar Municipality (Kapilvastu District)
6. Siddharthanagar Municipality (Rupandehi District)

III. Province 1

7. Biratnagar Metropolitan City (Morang District)
8. Mechinagar Municipality (Jhapa District)
9. Suryodaya Municipality (Ilam District)

This report will present the PMM results conducted in Dhangadhi Sub-Metropolitan City, Sudurpashchim Province between 14 and 21 August 2020.

1.2 MUNICIPALITY PROFILE

Dhangadhi Sub-Metropolitan City is situated in the Kailali District, in the far western region of Nepal. It was established in 1976 as Dhangadhi Municipality and promoted to Sub-Metropolitan City in 2015. At the altitude of 109 m above sea level, the municipality is 750 Km away from the capital city, Kathmandu. Situated in a plain, it covers a total of 261.75 Km sq. (see Map 1), and borders with Kailari Rural Municipality in the east, Mohana River in the west, Godawari and Gauriganga Municipality in the north, and India in the south. As per 2011 Nepal census, the population living in the area is 101,970 (51,439 men and 50,531 women).

The main sources of income, in order of relevance, are business, foreign employment, government services, labour work, and farming. The most common economic activities include sales at small shops and work in construction sites and factories. In Dhangadhi Sub-Metropolitan City there are a total of 8 urban health centres, including one zonal hospital and two health posts, for a total capacity of 150 beds. Registered health workers are 36, with 13 doctors, 9 nurses, 6 auxiliary nursing midwives, and 8 auxiliary health workers.

1.3 OBJECTIVES

The PMM has four main objectives:

  1. Identify travellers’ profiles and mobility patters which have health related impacts both within and/or outside the country.
  2. Identify vulnerable places where travellers or mobile populations gather and interact with each other or with local communities, which are at risk of both contracting and spreading infectious diseases and other health threats.
  3. Identify priority sites with limited capacities to prepare and respond to public health emergencies.
  4. Identify priority public health actions and resource allocations, in order to develop action plans aimed at strengthening public health emergency preparedness and response capacities.
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