Nepal is one of the world's poorest countries with 45% of the population living below the poverty line. As much as 50% of children under age of 3 suffer from stunted growth. The country is highly susceptible to natural disasters such as earthquakes, recurrent floods, and landslides. There are numerous gaps in health preparedness and mitigation. No hospital in the country completely meets earthquake resistant standards. An armed Maoist insurgency which began in 1996 has spread all over the country, seriously affecting 80% of the countryside, and leaving more than 12,000 people killed. Between 100,000 to 200,000 persons are internally displaced with difficult access to health care. Since the end of a unilateral insurgent ceasefire on 2 January 2006 a number of violent incidents have occurred. Concern has been raised that the violence will escalate further.
The insurgency has destroyed some sub health posts in the rural areas and the ratio of doctors to the population is one to every 18,000 persons. Structural problems of health staff absenteeism, lack of supervision and problems with the supply chain to remote areas are exacerbated by the violent conflict. Only 27% of the population has access to adequate sanitation and 30% lack access to safe drinking water. The main causes of morbidity are diarhorreal disease, dysentery, cholera and typhoid.