Photo of the Week: Decade of Change - Nepal

Photo: Sanjana Shrestha/Save the Children

Health workers in Nepal learn basic care like how to properly wrap a newborn at a Save the Children supported community-based newborn care training program.

In Nepal, Save the Children's Saving Newborn Lives program trains local women to deliver basic lifesaving care to mothers, newborns and children in their communities. Even when doctors are out of reach , community health workers are helping to reduce newborn and child mortality rates in Nepal. By investing in frontline health workers, more newborns and children have the potential to be saved. 

The recently released ten-year analysis, Newborn survival in Nepal: a decade of change and future implications, highlights the role that the Community Based Newborn Care Package (CB-NCP) played.

The Community-Based Newborn Care Package is delivered through the nationally available Female Community Health Volunteers (FCHV) and was piloted in 10 of 75 districts, with plans to increase to 35 districts in mid-2013. Innovation and scale up, especially of community-based packages, and public health interventions and commodities appear to move relatively rapidly in Nepal compared with some other countries.

The FCHV is identified as the pillar for implementation of CB-NCP. The FCHV, who are in continuous contact with the community people and from the same ward, will be provided with the performance based incentive at the completion of the set of identified activities. Major role undertaken by FCHV is to identify and counsel pregnant women, encourage institutional delivery, advice/accompany the mother to the health facility for delivery and provide home based newborn care on day 1, 3 and 7. Assess newborn and effective and timely referral of sick newborn to appropriate health facility.

Over the decade, Nepal’s neonatal mortality rate reduced by 3.6% per year, which is faster than the regional average (2.0%) but slower than national annual progress for mortality of children aged 1–59 months (7.7%) and maternal mortality (7.5%).

The authors of the supplement did state that rapid expansion of community care combined with an increase in facility births offer potential for scale up and accelerated impact, but facility quality of care is a critical priority for improving both maternal and neonatal health.

• Nepal Fact Cards - Newborn Survival in Nepal