Kathmandu, Dec. 4: No Auxiliary Nurse Midwife (ANM) has reached their duty stations in six rural municipalities in the hilly and mountainous districts even after their adjustment assigning their duty stations, said officials at the Ministry of Health. Health facilities there have thus been affected due to the lack of ANMs. Following the employees adjustment, most of the ANMs are now eying their desired stations, which is posing difficulty, said Spokesperson at the Ministry of Health and Population (MoHP), Mahendra Prasad Shrestha. As a result, most of ANM positions in rural municipalities in mountainous and rural areas have remained unstaffed, said Shrestha. According to Shrestha, none of the adjusted ANMs have reached Narphu and Nesyang Rural Municipalities of Manang district; Barhagaun Muktikshetra Rural Municipality of Mustang; Adhanchuli Rural Municipality of Humla; Saipal Rural Municipality of Bajhang and Chharka Tangsong Rural Municipality of Dolpa districts. The assigned staff numbers of ANMs in these rural municipalities are: 16 in Narphu, 15 in Nesyang, nine in Barhagaun, five in Adhanchuli, three in Saipal and nine in Chharka. After the conclusion of the adjustment process, these rural municipalities are facing shortage of ANMs. Likewise only one ANM is serving at Sirijanga Rural Municipality in Taplejung. Spokesperson Shrestha said that only a few ANMs assigned to majority of rural municipalities in mountainous and hilly regions had actually assumed their duties. Those deployed ANMs as per the staffing number in mountainous regions have neither reached nor reported at their duty stations, said Shrestha. Due to the lack of local health workers, the workplace have not been their choices, said Shrestha, adding that lack of local staff members have also posed difficulty in the employees adjustment process. There are not even the one fourth of the required staff and health assistances in the eastern hilly districts, including Bhojpur, Terhathum and Sankhuwasabha. However, all the posts in the three districts of the Kathmandu Valley and Terai districts are filled up, with overstaffing in some areas. However, most of the posts of health staff in the hilly and mountainous districts have remained almost vacant, said Shrestha, adding that only the urban areas have become the choice of health staff. The MoHP has been receiving letters from the municipalities having more than required staff members asking for sources to pay the extra health staff, said Shrestha.