Trends for Neonatal Deaths in Nepal (2001–2016) to Project Progress Towards the SDG Target in 2030, and Risk Factor Analyses to Focus Action

Abstract

Introduction Nepal has made considerable progress on improving child survival during the Millennium Development Goal period, however, further progress will require accelerated reduction in neonatal mortality. Neonatal survival is one of the priorities for Sustainable Development Goals 2030. This paper examines the trends, equity gaps and factors associated with neonatal mortality between 2001 and 2016 to assess the likelihood of Every Newborn Action Plan (ENAP) target being reached in Nepal by 2030. Methods This study used data from the 2001, 2006, 2011 and 2016 Nepal Demographic and Health Surveys. We examined neonatal mortality rate (NMR) across the socioeconomic strata and the annual rate of reduction (ARR) between 2001 and 2016. We assessed association of socio-demographic, maternal, obstetric and neonatal factors associated with neonatal mortality. Based on the ARR among the wealth quintile between 2001 and 2016, we made projection of NMR to achieve the ENAP target. Using the Lorenz curve, we calculated the inequity distribution among the wealth quintiles between 2001 and 2016.

Lessons from the field: progress towards the sustainable development goals in Nepal in federal transition of the state

“…To improve the alliance for better evidence for environmental health and climate change, implementation research is being rolled out for informed decision-making. To ensure the continual MDG momentum for maternal, newborn and child health, increased allocation of the budget has been made for improving sick newborn care as per the Nepal’s Every Newborn Action Plan 2016–2030 1…”

“…In Nepal, despite the decade-long internal conflict and unstable governments during the Millennium Development Goal (MDG) period, the progress in reducing maternal and child deaths has been praiseworthy. The under-five mortality reduced from 146 per 1000 live births to 42 per 1000 live births, and the maternal mortality ratio reduced by more than half between 1990 and 2015 1. More than 85% of the children were fully vaccinated as per national schedule in 2015 2.…”

“…The coverage of skilled attendance at birth was more than 90% among the women from the wealthiest families, but less than 40% among the women from the poorest families. Similarly, the wealthiest families have achieved neonatal mortality rate target for SDG, 12 per 1000 live births in 2017, while the poorest families will take an estimated further 40 years to achieve it 1…”

Mortality Rate and Prognostic Factors in Neonatal Tetanus: A 3-Year Analysis of Cases Presented to Turkey-Somalia Mogadishu Training and Research Hospital

“…19 Similarly, in a past study on trends for neonatal mortality in Nepal (2001-2016), authors reported the highest risk of neonatal mortality in women without a tetanus vaccination and those with poor educational attainment. 20 In addition, a meta-analysis of 16 studies (9 from Africa, 5 from Asia, and 2 from Europe) among 4,535 neonates revealed low birthweight and age at onset 6 days to be the significant determinants of poor survival among neonates with tetanus, 15 while at least two-dose immunization of pregnant women with TT was estimated to reduce mortality by 94%. 17 In a past study on risk factors associated with worse outcomes in neonatal tetanus conducted in a Vietnamese hospital with neonatal intensive care facilities, authors reported younger age (OR: 0.73 for each day increase in age), lower weight (OR: 0.11 for each kilogram increase in weight), delay in admission (OR: 3.77 for each day increase), and leukocytosis (OR: 1.17 for each 1000 cells increase) to be the predictors of poor survival.…”

Burden and consequence of birth defects in Nepal-evidence from prospective observational study

“…In Nepal, no national protocol regarding management and timely service provision for babies born with birth defects exists. To further accelerate the reduction of neonatal mortality rate to achieve the Sustainable Development Goals (SDG) target of 12 per 1000 live birth, it is critical to implement evidencebased interventions to prevent and manage birth defects [15,16]. This study will provide evidence on the prevalence, risk factors and health outcomes associated with birth defects across 12 hospitals in Nepal.…”