Market mechanisms for newborn health in Nepal

Abstract

BackgroundIn Nepal, hypothermia is a major risk factor for newborn survival, but the country’s public health care sector has insufficient capacity to improve newborn survival given the burden imposed by distance to health facilities and cost. Low-cost technology to provide newborn thermal care in resource-limited environments exists, but lacks effective distribution channels.This study aims to develop a private sector distribution model for dedicated newborn thermal care technology to ensure equitable access to thermal protection and ultimately improve newborn health in Nepal.MethodsWe conducted a document analysis of newborn health policy in Nepal and a scoping literature review of approaches to newborn hypothermia in the region, followed by qualitative interviews with key stakeholders of newborn health in Nepal.ResultsCurrent solutions addressing newborn hypothermia range from high-technology, high-cost incubators to low-cost behavioral interventions such as skin-to-skin care. However, none of these interventions are currently implemented at scale. A distribution model that provides incentives for community health volunteers and existing public health services in Nepal can deliver existing low-cost infant warmers to disadvantaged mothers where and when needed. Newborn technology can serve as an adjunct to skin-to-skin care and potentially create demand for newborn care practices.ConclusionHarnessing market forces could promote public health by raising awareness of newborn challenges, such as newborn hypothermia, and triggering demand for appropriate health technology and related health promotion behaviors. Market approaches to promoting public health have been somewhat neglected, especially in economically disadvantaged and vulnerable populations, and deserve greater attention in Nepal and other settings with limited public health service delivery capacity.

Neonatal hypothermia in Northern Uganda: a community-based cross-sectional study

“…Despite the generally impoverished nature of the study area, belonging to a relatively lower socialeconomic status was also a predictor of hypothermia in this population. Mothers with low socioeconomic status often lack resources to buy materials that can keep the neonate warm 42 and may have limited access to health information. 43 This should not be a big problem if the mother practices skin-to-skin care.…”

Disposable low-cost cardboard incubator for thermoregulation of stable preterm infant – a randomized controlled non-inferiority trial

“…This mattress needs charging every 4 h and does not need continuous power-supply [13] , while the LCI need a continuous 350 watt power source. Power supply is easily available in hospital settings, but availability of electricity in community settings is challenging [38] . LCI has been designed to readily use solar rechargeable batteries.…”

Global Infant Health

“…Low-cost technology to provide newborn thermal care in resource-limited environments exists but lacks effective distribution channels. Lunze et al (2017) developed a private sector distribution model for dedicated newborn thermal care technology to enhance equitable access to thermal protection and eventually decline in neonatal deaths. A distribution model that provides incentives for community health volunteers and existing public health services can deliver existing low-cost infant warmers to disadvantaged mothers where and when needed through social entrepreneurs, savings groups, and microcredit organizations.…”

“…Other innovative approaches include leveraging market mechanism could reach out vulnerable mother through private sectors to promote infant health (Lunze et al 2017). Open Innovation (Dandonoli 2013) and Multi-partner Research Program (Qazi et al 2013) can provide innovative collaborating opportunity to improve infant health.…”