CURRENT STATUS OF NEONATAL HEALTH IN NEPAL AND A
COMMUNITY BASED STRATEGY TO IMPROVE IT
Manandhar
DS1, Costello AM de La2
1 Mother Infant Research Activities
(MIRA), Kathmandu, Nepal
2 Institute of Child Health (ICH),
London, UK
Objective:
To review the current status of neonatal health in Nepal and a community
based strategy used to improve it
Methods:
Published data on neonatal health in Nepal and various programs started to
improve it will be reviewed. A community based strategy used by MIRA and ICH
to improve neonatal health in a district will be discussed.
Results:
27 % of babies are of low birth weight. Over 90 % of births occur at home
and are attended by untrained persons. Neonatal mortality rate of 50/1000
live births constitute 63 % of infant mortality rate. Three main causes of
neonatal death are birth asphyxia, low birth weight and its complications
and septicemia. Facilities for the care of sick neonates are very limited
and mainly confined to Kathmandu, capital of the country. The government's
Safe Motherhood Program launched in 1996 to reduce the very high maternal
mortality consists of mother-baby package. Although emphasis of this
program is mainly in saving life of the mother there is provision for
neonatal care. Geographical, socio-economic and other constraints have
caused major problems in providing neonatal care. MIRA in collaboration
with the ICH, London has started a community based newborn care program.
The main principles are bringing awareness among mothers about the basic care
of the newborn infants at home, strengthening of the health care facilities
and use of a community based worker to provide care to the baby at birth
and thereafter. The results of this intervention approach are expected
soon.
Conclusion:
Health status of the newborn infant in Nepal is still poor. Two thirds
of infant deaths occur in the newborn period. Safe Motherhood and other
programs started by the government and non-government agencies and
particularly a community based program started recently are expected to
improve the newborn infant’s health in the country.