1. Overview of Perinatal and Neonatal Health in Nepal Dr SR Manandhar (MBBS, MD) Pediatrician, KMCTH

2. Introduction Perinatal and neonatal mortality rate in Nepal is still very high Over the last 15 years, Nepal’s infant mortality rate has fallen from 82 to 48 per 1000 live births (NDHS 2006) May be due to programmes conducted through government and other organizations, including those for ARI and diarrhoeal diseases

3. But, very few programmes to reduce perinatal and neonatal deaths in Nepal  To reduce under 5 mortality rate  IMR and NMR should be reduced NMR and IMR constitutes 2/3 rd of under 5 mortality

4. Nepal is on the track to achieve MDG Target. If the current trend remains, the country will achieve MDG 4 earlier….

5. Nepal is on the track to achieve MDG Target. If the current trend remains, the country will achieve MDG 4 earlier….

7. MDG Target to reduce Child Mortality for Nepal T A R G E T - 5 Reduce by two-thirds 1990 and 2015 the under-5 mortality rate Indicators19911996200120062015 TARGET IMR10879644834 U5MR162118916154 NMR 465038.63315 Nepal Millennium Development Goals P R O G R E S S R E P O R T 2 0 0 5

9. NMR & IMR/1000 live birth (Trend) YearIMRNMRNMR in % of IMR 1996795063% 2001643960% 2006483369% 9

13. Direct causes of neonatal deaths In Nepal (Hospital based data) Infection Birth asphyxia/trauma Prematurity Hypothermia

14. Causes of stillbirths in Dhanusha % (Total = 601) Reference: Manandhar SR et al. Causes of stillbirths and neonatal deaths in Dhanusha District, Nepal: A verbal autopsy study. Kathmandu University Medical Journal (2010), Vol. 8, No. 1, Issue 29, 1-5 2 yrs (1 st Sept ‘06 – 31 st Aug’08)

15. Causes of neonatal deaths in Dhanusha Reference: Manandhar SR et al. Causes of stillbirths and neonatal deaths in Dhanusha District, Nepal: A verbal autopsy study. Kathmandu University Medical Journal (2010), Vol. 8, No. 1, Issue 29, 1-5 2 yrs (1 st Sept ‘06 – 31 st Aug’08)

16. 81% births at home 50% births attended by relative or other untrained persons 19% each by trained person » NDHS 2006 Delivery scenario of Nepal