The 7-Lesson Schoolteacher Assignment Example | Topics and Well Written Essays - 500 words

The 7-Lesson Schoolteacher - Assignment Example Parents know and understand their children, and are influential in their lives, even as they enter the teen years. The family is the main engine of education. â€Å"A family trained to snitch on each other is likely to be able to conceal any dangerous secrets. I assign a type of extended schooling called "homework", too, so that the surveillance travels into private households, where students might otherwise use free time to learn something unauthorized from a father or mother, or by apprenticing to some wise person in the neighborhood.† (Gatto, 1992) Schooling permits premature parent-child separation, and it does not avoid inappropriate pressure on children. Rose articulated â€Å"School can be a tremendously disori ­enting place. No matter how bad the school, you're going to encounter notions that don't fit with the assumptions and beliefs that you grew up with - maybe you'll hear these dissonant notions from teachers, maybe from the other students, and maybe you'll read them.† (Rose) It is because children spend most of their time at school; therefore, schooling does not create and maintain positive family relationships. Schooling is not good for children because the structure of school assumes that children are not natural learners, but must be forced to learn through the efforts of others. Natural learners do not need such a structure. Schooling is one of the attempts that does not follow the principle of natural learning and does not help children retain the curiosity, interest, and love of learning that every child has at birth.  

Blue Jeans Essay Example for Free

Blue Jeans Essay The article â€Å"Blue jeans: Born to last† by Leslie C. Smith was published in Globe and Mail in 1992. Smith gives the brief details and the history of world popular blue jeans. The main idea of the essay is that how blue jeans came into life and what does it represent. In 1980’s, during the time of gold rush, French cotton called denim came into being which replaced canvas and people called it jeans. In 1853, Levis Strauss German manufacturer, though of curving into miners’ tents. Furthermore, Levis Strauss plans to cut canvas into pants for workers because routine trouser does not accomplish the necessity of them. Also, it can be worn by common man and celebrities. Although, The blue jean is the symbol of equality. In the essay Blue Jeans: Born to last, the author Leslie C. Smith says that â€Å"Jeans are functional and down-to-earth and unisexual† (Dasgupta, pg.107). The author expressed the qualities of the blue jeans. He explained the jeans are very suitable and can be worn by either male or female. It is very realistic and purposeful. Moreover, it is comfortable and trendy. The author Leslie C. Smith also talked about the cowboys that: The favoured grab of cowboys, by the 1930s they were an established icon-one that Easterners. Fresh from their vacations on popular dude ranches, were happy to appreciate.(1992, pg. 106). According to this, the jeans become favoured among cowboys in 1930s and it was the symbol of tough nature of American people to the rest of the world. Hence, jeans become a representation of cowboys. It provided cowboys a different identity. Blue jeans: Born to last, highlight the details of the blue jeans and explained that how jeans introduced to the world and what does it represent. It has slang expressions and informal language. As blue jeans is the most preferred dress in the world. The main purpose of this essay is that a blue pair of jeans is the one common thing between a common man and a superstar as it is the symbol of equality. The audience of the essay is the common people. The essay conveys a good message of equality and harmony.

Impact of the Dollar Currency Base Metal on India

Impact of the Dollar Currency Base Metal on India Abstract: Currency Future is a future contract in which specified currency can be bought or sell at pre determined price and date. In developed nations like US and UK the currency price increment impact on physical trading volume, it decrease it on currency price increment and increase it on currency price decrement. Like this, same thing happened in developing nations. In India the base metals prices so much impacted due to currency future price volatility. In India, the currency future trading was started on 29th Aug. 2008 in National Stock Exchange (NSE), in Multi Commodity Exchange (MCX) on 7th Oct. 2008 and in Bombay Stock Exchange on 1st Oct. 2008. The objective of this paper is to measure the correlation of base metals with currency future trading i.e. US $. This research paper is an attempt to consider the investor behaviour regarding currency future trading in India. Some factors which have been considered for research are currency future, base metals and price movement in upward or i n downward side. The results are analyzed with the help of statistical tools and techniques. Introduction Currency Futures means a standardised foreign exchange derivatives contract traded on a recognised stock exchange to buy or sell one currency against another on a specified future date, at a price specified on the date of contract, but does not include a forward contract. Currency derivatives can be described as contracts between sellers and buyers whose values are derived from the underlying which in this case is the exchange rate. Currency Derivatives are mostly designed for hedging purposes, although they are also used as instruments for speculation. Currency Derivatives i.e. Currency Future are standardised in terms of contract sizes, trading parameters settlement procedures and traded on regulated exchange. The contract size is fixed and is referred to as lot size. Future contract are traded through exchanges, the settlement of the contract is guaranteed by the exchange or clearing corporation and hence there is no counter party risk. In INDIA the currency future trading was started on 29th Aug. 2008 in National Stock Exchange (NSE), in Multi Commodity Exchange (MCX) on 7th Oct. 2008 and in Bombay Stock Exchange on 1st Oct. 2008. Currency Future trading play a vital role in developed nations and developing nations. It makes the so much volatility in metal prices in terms of online trading as well as in physical trading. After the starting of currency future trading in India the volatility increase in the MCX non precious metal. The total number of contract traded before starting of currency future trading in non precious metal are 84186 (lots) and after the starting of currency future trading 69358 (lots). It shows that there is lot of volatility in the metal market sometime it increases the volume or sometime it decrease the volume. Multi Commodity Exchange of India Ltd (MCX) is a state of the art electronic commodity future exchange. The head quartered of MCX in Mumbai. The demutualised exchange set up by Financial Technologies (India) Ltd (FTIL) has permanent recognition from the Government of India to facilitate online trading and clearing and settlement operations for commodity futures across the country. The operations started in Nov 2003. MCX offers more than 40 commodities across various segments such as bullion, ferrous and non ferrous metals and a number of agro-commodities on its platform. The exchange is the worlds largest exchange in Silver, the second largest in Gold and Copper. MCX has been certified to three ISO standards including ISO 9001- 2000 Quality Management System standard, ISO 14001: 2004 Environmental Management System standard and ISO 27001:2005 Information Security Management System standard. Literature Review Since the beginning of trading in financial futures and options in the 1970s, the effect of financial derivatives trading on the underlying spot markets has been of great interest to both academics and practitioners. One of the issues commonly investigated by finance researchers is whether futures trading increases the price volatility of underlying markets and thus leads to destabilisation of these markets. Previous studies provide mixed evidence on this issue. To investigating the market behaviours (such as currency price volatility, metal market depth and trading volume) is an important aspect of research on the market microstructure literature. Tauchen and Pitts (1983)1 argue that these three variables are closely related. However, most studies deal with mutual contemporaneous relationship between two of those three dimensions and reach no consistent results. Very few empirical papers investigate the dynamic nature of the interactions, such as the feedback effects between those three variables. The relationship between currency future and trading volume has been examined frequently and usually is in a positive correlation between volatility and trading volume. Copeland (1976)2, develop sequential arrival of information models where new information flows into market to generate both trading volume and price movement. Karpoff (1987)3, reviews empirical and theoretical research on the relation between price changes and trading volume in financial markets. Eighteen of nineteen empirical papers support the positive correlation between volatility and trading volume. Bessembinder and Segun (1993)4 accommodate persistence in the positive relationship on eight futures market by ARCH-GARCH empirical method. In those studies above, it is consistently positive contemporaneous relation between return volatility and trading volume but lacks consistent in the relation between return volatility and market depth or between market depth and trading volume. Furthermore, there are few studies for the analysis of return volatility and trading volume incorporating with the market depth, which is proven to be fundamentally related to trading activity and market behaviour of return volatility (Bessembinder and Seguin, 1992)5. As suggested by Malliaris (1997)6, the origin of futures markets is related to the necessity to manage the risk associated with volatile spot price changes of certain assets. It can also be claimed that futures contracts became more popular since the economic deregulation in 1970s, which resulted in increased volatility in foreign currencies, debt instruments and stock indexes. Market observers and regulators have generally acknowledged the crucial role that futures markets have in risk transfer and price discovery, but they have often expressed concern over the potential role that futures activity may have in destabilizing the markets. Antoniou and Holmes (1995)7 examined the impact of trading in the FTSE-100 index futures on the spot price volatility and concluded that futures trading improves the quality and speed of information flowing to spot markets. Their evidence suggests that there has been an increase in spot price daily volatility, but that this due to increased information in the market and not to speculators having adverse destabilizing effect. Some studies provide empirical results that support the opinion that trading in futures can destabilize the spot market. For example, Figlewiski (1980)8 investigates the futures contracts for Treasury Bills (GNMA pass through certificates) and provides evidence that futures market activity increases the volatility of cash prices. More recent study by Bae, Kwon and Park (2004)9 focuses on the effect of the introduction of index futures trading in the Korean markets on spot price volatility. The authors concluded that introducing the futures and options trading on the Korean stock exchange resulted in both larger spot price volatility and greater market efficiency (allowing for quicker adjustment of market prices to information). The combined average daily turnover of the currency futures contracts in all the three exchanges (NSE, BSE, MCX) increased from USD 1.1 billion in March 2009 to 2.5 billion in September 2009 – which means a growth of more than 125% in just six months period. Objectives of Research Paper To know the impact of Currency Future US$ on base metal with reference to India. Hypothesis of Research Paper Null Hypothesis: There is positive impact of currency future US$ on base metals, if US$ increases than the price of base metals increases and vice versa. Data Analysis The impact of currency future i.e. US$ on base metals is totally depend on the day to day trading prices of currency as well as metals. To find out the impact of currency on base metals we need the daily transaction prices, for this we collect it from secondary resources. To find out the correlation of currency future and base metals I summarise the data in average form. I collected per day USD INR pricing data for twenty seven months and calculated its average per month. For the base metals, I selected five metals (viz. Aluminium, Copper, Lead, Nickel, and Zinc) collected their pricing data for each day for twenty seven months and calculated its average per month. Here we can see in the table no. 2 there is correlation coefficient between currency future and base metals. Aluminium, Copper, Lead, Nickel and Zinc are inversely correlated to currency future. There is impact on the Aluminium -0.787, the copper -0.267, lead -0.770, nickel -0.897 and zinc -0.850. When the currency future prices raise the base metals prices decrease and sometimes the base metals prices increase. It shows that the currency future and base metals are inversely correlated. Conclusion The data analysis of the currency future and the base metals shows that there is a correlation between them. When there is volatility in the currency future and base metals it impacts the relation between them. Sometimes it makes the positive relation between currency future and base metals and sometimes it makes the negative relation between them. Due to this the economic condition of India is so much impacted. When the prices volatility increases in base metals it creates the problem in physical metals trading that impact directly or indirectly to the economic condition of our nation. The data analysis represents the inverse linear relationship between currency future and base metals. Scope of research There is so much scope of this research because it is a new concept in India. Before two years ago the currency future trading was started in India. The currency future trading is a concept which is not very common. People are not so much aware about it. This paper is related with base metals only but further the whole metal market is influenced by it.

Marketing Variable Mix Of Prod :: essays research papers

INTRODUCTION   Ã‚  Ã‚  Ã‚  Ã‚  The Japanese have again burst into the technology industry with the introduction of their newest product, Aibo, the robotic pet dog. Aibo is a Japanese word short for â€Å"companion†, and it also stands for Artificial Intelligence Robot. This creature is able to navigate its environment and respond to changes. This highly innovative idea began back in 1994 when Toshi T. Doi, Sony Corporations lead engineer, enlisted an artificial intelligence expert named Masarhiro Fujita to formulate a robot with sophisticated sensors. Fujita took just two weeks to develop the first prototype robotic creature that led to this current venture. AIBO’S TANGIBLE PRODUCT ATTRIBUTES   Ã‚  Ã‚  Ã‚  Ã‚  No larger than a Chihuahua and constructed primarily of magnesium alloy, Aibo is equipped with infrared sensors and cameras for eyes that allow it to judge distance and avoid walking into objects. It also has sensors on its head, in its paws, and an antenna for a tail. Aibo is programmed to enjoy being petted and dislikes being scolded, not unlike real dogs. It also shows happiness by wagging its tail and illuminating its green eyes. Aibo can perform some standard tricks such as sitting and begging, and it can even dance and play music. As sophisticated as it may be, Aibo can not respond to voice commands, and it requires a remote control that emits musical tones the robot recognizes as commands. AIBO’S AUGMENTED AND GENERIC PRODUCT ATTRIBUTES   Ã‚  Ã‚  Ã‚  Ã‚  Aibo’s augmented product attributes revolve around the Sony brand name. Sony is a well-established corporation in the electronics industry. It is the most recognized brand name in the world, evoking a status of quality and dependability. Aibo will have a considerable lure on customers keen on cutting-edge gadgets. The first of its kind in sophistication and advanced robotics, Aibo will carry a significant status for technology buffs and expensive electronic toy collectors who can afford them.   Ã‚  Ã‚  Ã‚  Ã‚  From a generic product perspective, Aibo is already winning over the hearts and minds of consumers. Its almost life like touches and actions such as the occasional yawn, flopping on its belly when it’s bored, and the wagging of its tail when it is happy is rapidly captivating people all over. For some, the appeal is in the joy of owning such a technological and futuristic marvel. For others, It may be the hope of companionship from and innate object, not unlike today’s interactive computers. For most consumers it is just plain and simple entertainment.

Salem Trials: A Lesson from History

Salem was taken from the word, â€Å"Jerusalem†, seat of Christianity. This is where Christ trudged on and lived a holy life but became ironically symbolized in America by people become crazy. It has gained notoriety due to cruelty that pervaded in 1692 in that village in Massachusetts. â€Å"Time is the Mother of Truth and Truth the Daughter of Time† (Hale), scholars have studied documents surrounding that incident in Salem. The truth was told through documented events of those fateful days when those innocent people were tagged as ‘witches’. The people of Salem acted on suspicion without substantial bases for accusing one hundred fifty villagers of a crime that is ‘witchcraft’. They have admitted to a mistake that was horrible, became a controversy for ages, and a lesson for humanity. (Hale) Several factors influenced the villagers to act in such frenzy: politics, religion, and hysteria. For lack of a strong leader who can effectively give direction to the people’s thinking, the incident went out of hand. Even the leaders themselves were controlled by the situation, perhaps, due to hidden interests as well. P. S. Nissenbaum) Internal bickering in the community is not exceptional for it also occurs in other New England communities at that time. Add to it a weak institution that can handle the population. They were claiming to see an apparition of the witches at their beds. (P. B. Nissenbaum) Having them hanged will not make any difference using that argument. The devil can harm them in whatever form us ing their kind of thinking. It is incomprehensible how individuals can be united to wreak havoc upon other individuals. People of such ignorance have been put together to teach humanity how extremism and stupidity can cause such a tragedy. The lives of the people who were innocent of a crime that is witchcraft which was not proven enough were put to waste due to the cruelty that beset upon them. They had to suffer in jail and have to go through torture because their co-villagers were obsessed with the idea of a devil that is lurking around their lives and is causing an illness which they do not understand. They used the words: â€Å"fits†, â€Å"odd postures†, â€Å"foolish, ridiculous speeches†, â€Å"distempers†, etc. o describe what are being manifested by the victims of witchcraft as they said. (P. S. Nissenbaum) One was seen crawling on the floor during an attack. (P. S. Nissenbaum) The symptoms that were being manifested by the said victims of witchcraft could be epilepsy. This illness has always been associated with demonic possession which can not be cured. The stig ma that can be brought upon the individual experiencing this can be enormous that it is convenient to blame it on somebody performing witchcraft upon him/her experiencing it. This can be genetic and in Salem during that time, having fifteen children in a family was the average. It is not negligible to note that this disease could be running in families. Not to mention the hysteria that came with it. Children were manipulated by adults to say things or even their musings were interpreted to mean according to how they wanted it to mean. (P. S. Nissenbaum) The colonies of England included Massachusetts which was under the laws that govern these colonies. In England, witchcraft was a capital crime as declared in 1641. Chronology of Events Relating to the Salem Witchcraft Trials) Anyone suspecting of witchcraft activities were hanged by the stake. The colonial village of Salem was a staunch believer of the Bible. They took to the letter every bit of the Scriptures. They have become extremists that they have forgotten that ‘love’ was taught by Christ primarily. The ministers who were at a loss in governing the villagers conveniently blame witchcraf t as the culprit in the disunity eminent among the folks. Disputes led the villagers to falsely accuse innocent citizens in response to the hysteria that pervaded them. The early ministers who led them were also blinded by their desire for territory. It was a difficult time for this colonial town. Land was getting scarce while families were becoming big. They work very hard on their farms only to be obliterated by blights. (P. S. Nissenbaum) Children were not allowed to play: girls were taught to spin yarn and help in the household while the boys were brought by the men to help them to hunt. They did not have the opportunity to play as normal children would. These children were deprived of the happiness of childhood. It is not surprising if they would deliberately act out abnormal behavior because opportunities to play were rare. It is possible that acting out those eccentricities was a form of ‘play’ for these deprived children. Their sense of awe and wonder were suppressed by the adults. Their words were twisted by the older ones to serve their purpose. (P. B. Nissenbaum) They lived at a time when there were no other forms of entertainment but chores. It was also a time for New England to be established. Institutionalizing law and order was especially difficult in this part of the colony. Political disputes were prevailing in terms of who would minister the community. They were like a flock in need of a shepherd. But the shepherds who should be taking care of them also have vested interests. They carry within them their wants and needs. The chronology of events is very telling about man’s desire for power and control. The judicial system was used and manipulated according to the whims of the judges. (Chronology of Events Relating to the Salem Witchcraft Trials) The humble investigation of John Hale speaks of how erroneous the system is in handling the cases in Salem. With all humility he explained that what transpired in Salem was a lesson learned for humanity. Quoting from the Scriptures, he reiterated that the innocent must not suffer. (Hale) The evidence against them was obviously weak based on spectral evidence that Governor Phipps opposed. (Chronology of Events Relating to the Salem Witchcraft Trials) He was able to save lives due to be hanged in the Gallows. After fourteen years, one of the accusers, Ann Putnam, publicly apologizes for her actions in 1692. The event in 1692 was very unfortunate for the people in Salem. Hysteria emanated in that village due to numerous factors. One would see how religious extremism can drive people to do harm towards others which are contrary to the teachings of religion. Greed and desire for power can attribute to people’s insensitivity and delusions. It was formally admitted as a mistake by the government of Massachusetts in 1957 (Chronology of Events Relating to the Salem Witchcraft Trials) and a good reminder for everyone of the cruelty that occurred centuries ago. This is a lesson learned which must be avoided. It is important that judicial system must be respected by honoring facts; biases must be avoided; and the right to be represented must be observed. Law and order are present for people’s protection. These should not be used to cause harm to a nation’s citizens. Leaders appointed are also responsible of the people’s safety. They must safeguard the lives entrusted them. It is important for them to ensure that due process must be served in the courts. This incident must never happen again.

Neonatal Health Care in Nepal

NEONATAL HEALTH CARE in NEPAL 1. BACKGROUND In the mid way of 2000 and 2015, the analysis of Millennium Development Goals (MDGs) in developing world shows encouraging progress signs particularly in child health, but very less or no notable achievements in neonatal health (WHO, 2009). The proportion of neonatal deaths – deaths within the first 28 days of life – is expected to increase due to decline in burden of post-neonatal deaths (UN, 2009; USAID, 2008; WHOSIS, 2010).As per the WHO Statistics (2009), the progress on health-related MDGs shows about 37% of under-five (U-5) mortality occurs in the neonatal period, with most deaths within the first week i. e. early neonatal period. Over one million neonates die within their first 24hours of life due to lack of quality care, annually, worldwide (UNFPA, 2008). In Nepal, Neonatal Mortality Rate (NMR) is 32 per 1000 live births in 2004 (WHO, 2009). Fig 1 Continuum of care Source: Kerber et al. , 2007 The basic principle of de veloping strategies to address Neonatal Health Care (NHC) revolves round the ‘continuum of care’.Throughout the lifecycle as shown in figure 1, including adolescence, pregnancy, childbirth and childhood, the care ought to be provided as a seamless continuum that spans the home, the community and health centre, locally and globally (Save the Children [StC], 2006). Hence, reducing child mortality is more dependent on tackling neonatal mortality or in other words, managing the NHC. 2. KEY CONCEPTS AND ISSUES In Nepal, most of the deliveries take place at home with delayed care-seeking behavior; the NMR remains high in rural areas, frequently associated with cessation of suckling and shortness of breath (Mesko et al. 2003). While the Department for International Development [DFID] (2009) report reveals that, the factors causing poor maternal outcomes and ultimately resulting high NMR are poor and delayed transportation arrangements, weak financial status, long distance to h ealth centre, and even needing permission to seek care. As the survival of the newborns, older than a month is progressing quickly, there has been transformed concern in interventions assumed to improve neonatal survival.The questions about the new interventions: â€Å"providing thermal care to the newborn, postnatal care to the mother and newborn, and counseling on infant and maternal health care to mothers† has been added in the Demographic Health Surveys (DHS) of Nepal, along with Bangladesh, India, Indonesia, and the Philippines, to address antepartum, intrapartum, and postnatal interventions for the NHC (USAID 2008). Moreover, the target to reduce NMR from 34 to 30 per 1000 live births by 2010 has been set in the new Three Years Interim Plan (TYIP) for health 2008-10 (TYIP 2008-10, 2008).Pertaining to the revised target associated with neonatal mortality and to combat delays in seeking, reaching and receiving care, the Department of Health Services, Nepal (DoHS 2006/07, 2008) has postulated three major strategies: * To promote birth preparedness and complication readiness including raising awareness, improving the availability of funds, transport and blood supplies. * To promote use of skilled birth attendants at every birth, either at home or in a health facility. * To make provision of 24-hour emergency obstetrics care services (basic and comprehensive) at selected public health facilities in every district. . STRENGTHS AND WEAKNESSES The strengths and weaknesses of the NHC in Nepal can be reflected in broad spectrum, by analyzing the strengths and weaknesses of the National Health Policy and current heath services, in general. 4. 1. Strengths 4. 2. 1. Health as citizen’s right The Ministry of Health and Population (MoHP) aims to create a new healthy Nepali society, working in alignment with the prime objective of â€Å"bringing about a meaningful change in the overall health† as per the guidelines issued by the Government of Nepal (GoN) to establish health as a fundamental human right of each and every Nepalese. . 2. 2. Decentralization of health policy Decentralization in health policy – a starting point for consultation – and its implementation is under process, initiated with the coordination between the MoHP and Ministry of Local Development (MoLD). The major objective of the decentralization in health policy is to improve cost efficiency and effectiveness of government action, and strengthen community approach (DFID, 2003). The respective Village Development Committee has been handed over the administrative and financial management tasks, initiatives taken from the lowest level, i. . Sub-health Posts (NHSP, 2009). 4. 2. 3. Public Private Partnership The private sector’s involvement to a considerable extent is noteworthy (TYIP, 2008) in the Public Private Partnership (PPP) which initiated since 1950s (MoHP, 2008). The PPP has created continuous and uniform coordination of intervention s such as immunization and pneumonia treatment, significantly reducing children and neonatal mortality (UNDP, 2010). 4. 2. 4. Community based interventions Fig. 2 Neonatal mortality in past 15 yearsSource: DoHS (2006) The development and implementation of community-wide protocols has significantly reduced the NMR in the past 15 years, as shown in figure 2 (DoHS, 2006); and aims to ensure access to effective healthcare focusing the neonates, in a sustainable and equitable manner. A study conducted by Dutta (2009) reveals that home-based newborn care has been significant in about one-third to two-third reduction in neonatal mortality after home based care interventions. Whilst, a study conducted by Haines et al. (2007) reveals that the mobilization of local women through community based participatory intervention can be significant in improving the health of the newborn. 4. 2. Weaknesses 4. 3. 5. Weakening and unsafe care The weakly designed system, unable to ensure safety and hygiene standards has been enforcing high rates of acquired infection during the birth, along with medication errors and other avoidable adverse effects (IDA and IMF, 2007). 4. 3. 6. Uneven and fragmenting health care The broadening of specialized health care and cutting interest in the disease ontrol programmes, do not realize for the continuity of care. Due to poor and highly under-resourced infrastructure, the health services for poor and marginalized group of Nepalese is highly uneven, aiding fragmentation of development (WHO Report, 2008). 4. 3. 7. Inequity Equity in health care as a basic need to ensure highest possible minimum standards, has not been attainable. The majority of the care is redeemed by the people with the most means but with lesser need, while the neonatal health care in the rural areas remain almost virgin, with no redistribution of resources (WHO, 2008). . 3. 8. Others According to TYIP for health 2008-10 (2008), there are some general weaknesses largely affecting the novel objective of providing quality health care service that are easily accessible by all the citizens, also influencing the target of reducing the NMR in Nepal, such as; * lack of skilled human resources and problems in their mobilization to rural areas, * very slow pace of decentralization process, * inadequate supply of equipment and drug, * political interference in management, * weak monitoring and supervision, and lack of physical infrastructure and its inadequate repair and maintenance (TYIP 2008-10, 2008). 4. EFFECTIVENESS The performance of a nation’s health system can be judged against WHO Criteria: health status of the population and inequality, responsiveness and inequality in responsiveness and fair financing (WHO 2000); and Managing Cost, Care and Health Framework. 5. 3. WHO Criteria According to the WHO Report (2000), the health level of Nepal is ranked at 142 with Disability Adjusted Life Expectancy (DALE) of total population at birth 49. years, as shown in table 1. Table 1 Health system attainment and performance in Nepal, ranked by eight measures, estimates for 1997 ATTAINMENT OF GOALS| Health expenditures in international dollars| PERFORMANCE| Health Level| Health Distribution| Responsiveness| Fairness in financial contribution| Overall goal attainment| | | DALE (in years)| Equality of child survival| | | | | Level of health| Overall health system performance| Rank| Total Pop. at birth| Rank| Index| Uncertainty Interval| Level| Distribution| | | | | | 142| 49. 5| 161| 0. 585| 0. 513-0. 63| 185| 166-167| 186| 160| 170| 98| 150| There remains possibility of large inequality in the care provided at the rural and urban settings due to very poor health settings of workforce (DoHS, 2006). The inequality in responsiveness with very low respect profile for others and very poor quality of amenities has placed Nepal at 185 level, and the rank of 186 (sixth from the bottom) shows that each household faces very high financial risk and spend largely for healthcare, thus purchase of needed care enforces into poverty (WHO, 2000). 5. 4. Managing Cost, Care and HealthGoing with the global approach, Nepal has also adopted decentralized health care system, attempting â€Å"to make providers both independent and more accountable for the cost and quality of the healthcare services† (Kane and Turnbull, 2003). The supplier and consumer approach can hardly be realized in the health service provided by the government; effectiveness of the NHC – dominantly under the control of government – can be evaluated against the framework of managing costs at affordable levels, improved quality and access, and advanced health of the population (Kane and Turnbull, 2003). . 5. 9. Managing Cost The fairly existing systems operated by small number of agencies provide membership to the clients, cost borne by the clients or their employers on installment basis. The employees of government sector and labour organization are suppo rted with healthcare cost borne by social support schemes (WHO, 2003). There has been significant decrease in financial resources in the health sector due to shoot-up of concerns in conflict resolution and internal security (NHSP, 2009). The maximum portion of health financing is from out-of-pocket payment, i. . 85. 20% (WHO 2009), and there has been increased competition among the (private healthcare) providers to deliver the responsive behavior to the care-seekers (patients). But the larger portion of the consumers’ right to have an option of choosing economic and most compatible supplier still remains virgin. The Second Long Term Health Plan (SLTHP) 1997-2017 has emphasized the importance of restructuring healthcare and health insurance options, which has already been introduced but is almost non-existent.Delayed acknowledgement of managing insurance risk has lit some hope of effective healthcare, while managing utilization of services, and managing provider and supplier p rices are just unimaginable. 5. 5. 10. Managing Care Fig 3 Neonatal Mortality factors and interventions to reduce it Source: USAID 2008 NEONATAL MORTALITY Strengthening of Health Care System Ante-natal Care Neonatal Resuscitation Breast-feeding Clean DeliveryIntermittent preventive treatment for malaria Micronutrient supplementation Health Education Delivery by a Skilled Birth Attendant INTERVENTIONS The factors associated with neonatal mortality (as in figure 2) suggests that managing care can be improved and millions of new born be saved by approaching health issues of maternal care, neonatal care and child health, under the same umbrella; and interventions can be operated with lower cost (StC, 2006).The policies and programmes in packages can cut down the cost of training, monitoring and evaluation, and facilitate judicious use of the available resources, with greater efficiency and more effective coverage of the beneficiaries. 5. 5. 11. Managing Health Despite reduced neonatal m ortality trends in Nepal over the past 15 years (NDHS, 2006), the neonatal morbidity and mortality still represents major proportion of U-5 child mortality; principally due to the lack of SBAs, poor referral systems and lack of access to life-saving emergency obstetric care when complications occur (Safe Motherhood 2010).The revised National Safe Motherhood Health Long Term Plan 2006-2017 in accordance with SLTHP 1997-2017 focuses on improving maternal and neonatal health, and has aimed to reduce NMR to 15 per 1,000 live births by 2017; targeting to increase deliveries attended by SBAs to 60% and deliveries in a health facility to 40%, by 2017, increasing the met need of emergency obstetric complications by 3% and of caesarean section by 4%, each year (Safe Motherhood 2010).The Partnership for Maternal, Newborn, and Child Health (PMNCH) formed by merging three separate entities – newborn, maternal and child health partnership – has been established. This joint venture aims â€Å"[t]o create a more unified voice and facilitate creation of a continuum of care, work for achievement of maternal and child health-related MDGs by strengthening and coordinating action at all levels; promoting rapid scale-up of proven, cost-effective interventions† aligning the resources with the objectives, more efficiently and effectively (StC, 2006). 5.CHALLENGES and PRACTICALITIES 6. 5. Contextual Challenges * Low birth weight (14. 3%) and underweight (38. 6%) are the root causes of perinatal deaths (MoHP, 2007). * The nation wide campaign of polio (78%), measles (81%) and tetanus (83%) immunisation by 2007, had immense significance in reducing the child deaths (WHO 2009). Despite having 60% children fully immunized, disparity remains in service coverage as 8% of U-5C are not immunized at all (MDG 2005). * Though the poor people have moved closer to the poverty line with poverty gap ratio declining from 0. 12 to 0. 75, child malnutrition still remains another m ajor challenge for Nepal, which is the underlying cause for 50% of children deaths. Though, improved health and nutrition of the mother and availability of the SBAs can play role in reducing the NMR, it seems devastating to maintain the coverage rates with ongoing political conflicts and security problems. Hence, revisited strategies to combat this challenge will be more effective in reducing NMR due to the above contextual challenges. 6. 6. Leadership Challenges 6. 7. 12. Level of system funding With total expenditure on health 5. 1% of the GDP, and 30. % share of governments’ expenditure on health – the shortfall met by private spending (WHO, 2009) – reflects low political will and ability to invest in managerial and administrative infrastructure (Kane and Turnbull, 2003). This condition is prone to inhibit pooling of risks and the citizens are always prone to catastrophic payments, further aggravating the poverty in the poorer community like Nepal (WHO, 2009) . There is an alarming need of allocating financial resources for patient registration, disseminating information, monitoring and follow-up activities, and any other active management of the health services. 6. 7. 13.Provider market structure Nepal health market has countable specialists, very few care practitioners and poorly developed communication among the suppliers; lacking primary care capacity. As the large multispecialty of the provider market structure with influential medical leadership facilitates the success of managed healthcare mechanisms, there remains huge modification in the provider market structure. 6. 7. 14. Proportion of the population covered by health insurance In the span of six years, from 2000 to 2006, there has been decrease in out-of pocket expenditure from 91. 2% to 85. 2% of private expenditure on health.