Plan to protect newborns in eight more districts

 Article originay published in The Himalayan Times. 

KATHMANDU: The Ministry of Health and Population has expanded its Community Based Newborn Care Package (CB-NCP) programme in eight more districts — Baitadi, Kanchanpur, Lamjung, Bara, Taplejung, Humla, Baglung and Dolpa — this year as a direct intervention to reduce neonatal mortality rate (death within the first 28 days of life).The government has been running the programme in 25 districts since the last fiscal.

Parshuram Shrestha, chief of the Integrated Management of Childhood Illness at the Child Health Division, said preliminary findings of the programme suggest the programme to be highly effective as more births are taking place at health centres and more families are opting for essential newborn care and seeking treatment for complications.

He said the significant factor for the neonatal death are the gap in the continuum of care, low institutional deliveries, lack of skilled care at pregnancy, delivery and post-natal period, inadequate access to and utilisation of quality care, and poor maternal nutrition. Through CB-NCP, the government is providing five essential messages to community to prevent the neonatal death. The messages are to wipe the newborn with soft and dry cloth immediately after birth, holding the newborn against the mother’s chest and initiating skin-to-skin contact, advising and support the mother on early and exclusive breastfeeding after birth and exclusive breastfeeding till six months, not putting anything on the cord stump, keeping it clean and dry to protect from infection and giving bath to the newborn only after 24 hours of birth.

Under the programme, the Female Community Health Volunteers will visit the newborn in the first, third, seventh and 28th days. He added that they will provide counselling to mother and family members to protect the newborn from various diseases.

According to the ministry, the leading causes of neonatal death are infection, which accounts for 36 per cent of all neonatal deaths, low birth weight (27 per cent) and asphyxia (23 per cent). The World Health Organisation data show that 32 per cent neonates die of infection, 29 per cent of asphyxia and injury and 24 per cent of premature and low birth weight worldwide. The neonatal mortality rate in the past five years was 33 deaths per 1,000 live births according to the Nepal Demographic Health Survey-2011. Under the Millennium Development Goals, the country aims to bring down the number of neonatal deaths to 17 per 1,000 live births by 2015. First experimented in Morang in 2007 as Morang Innovative Neonatal Intervention, the programme was hugely successful in reducing and was expanded to nine more districts — Dhankuta, Sunsari, Parsa, Kavre, Dang, Bardia, Doti, Palpa and Chitwan — in 2009.