Abstract

Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implemented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.

Highlights

  • Disparity in the unequal distribution of the neonatal mortality rate (NMR) has been reported among different regions, religious, and ethnic groups in Nepal

  • Having four antenatal care (ANC) visits or the childbirth assisted by a skilled birth attendant (SBA) halves the risk of neonatal death

  • This study aims to summarize the health system challenges and possible solutions for specific interventions focused on reducing neonatal deaths

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Summary

Newborn Health interventions and challenges for implementation in Nepal

Resham Bahadur Khatri1* , Shiva Raj Mishra , Vishnu Khanal2,3 , Khageshwor Gelal and Subas Neupane. The Government of Nepal has implemented community-based programs that were piloted and scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.

INTRODUCTION
TRENDS OF CHILD MORTALITY IN NEPAL
POLICIES AND PROGRAMS FOR NEWBORN HEALTH IN NEPAL
NEWBORN HEALTH INTERVENTIONS AND THEIR IMPLEMENTATION STATUS
CHALLENGES IN THE IMPLEMENTATION OF NEWBORN HEALTH INTERVENTIONS
Care for all newborns
KMC for stable preterm
Guideline is yet to be developed
Findings
CONCLUSION
Full Text
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