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Community and Home-Based Interventions in Nepal

Impact of community- and home-based interventions for improved newborn care practices in Nepal (completed)

Nepal is one of the few developing countries considered “on track” to achieve Millennium Development Goal 4 to reduce child mortality. Nevertheless, advances in neonatal health have been limited and have prompted the Government of Nepal to develop the Community-Based Newborn Care Package (CB-NCP). This programme comprises a broad range of activities to promote behavior change, institutional delivery or clean home delivery, postnatal care including care of low birth weight newborns, management of newborn infections, prevention of hypothermia, recognition of asphyxia, initial stimulation and resuscitation, and use of chlorhexidine for cord care. Implementation in 10 out of 75 districts of Nepal started in 2007.

In the context of his PhD research, Dr. Deepak Paudel (CIHLMU) in cooperation with Dr. Eva Rehfuess (Institute for Medical Informatics, Biometry and Epidemiology, LMU), Prof. Ishwar Shrestha (Department of Community Medicine & Public Health, Tribhuvan University) and Prof. Matthias Siebeck (Department of Surgery, LMU) undertook an evaluation of the impact of the CB-NCP on essential practices to improve neonatal health using a mixed-method quasi-experimental approach. The impact of the community-based newborn care package was assessed by comparing progress in propensity score-matched intervention and comparison areas, utilising data from existing nationally representative surveys and from the Nepal Ministry of Health’s management information system. The views of programme beneficiaries, important family and community members and service providers obtained through focus groups and key informants are used to distil factors that enable or restrain improvements in newborn health. Quantitative findings across multiple data sources and qualitative findings are triangulated to offer a holistic evaluation of the CB-NCP. The results of this research are forthcoming and are already informing how the programme will be upscaled in other districts of Nepal.

Involved CIH Partners

Department of Community Medicine & Public Health, Tribhuvan University

Institute for Medical Informatics, Biometry and Epidemiology, LMU