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A community-based neonatal care package in Nepal improved delivery cleanliness and prenatal visits but did not reduce neonatal mortality. Further examination of volunteer roles and supply-side constraints is suggested.

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Area of Science:

  • Public Health
  • Maternal and Child Health
  • Global Health

Background:

  • Neonatal mortality remains a significant global health challenge, particularly in low-resource settings.
  • Nepal faces high neonatal mortality rates, with 22 deaths per 1000 live births within the first month.
  • Community-based interventions are crucial for improving newborn health outcomes.

Purpose of the Study:

  • To evaluate the impact of a Community-Based Neonatal Care Package on neonatal mortality in Nepal.
  • To assess the program's effect on intermediate outcomes such as delivery practices and healthcare utilization.

Main Methods:

  • Utilized nationally representative data from Nepal for a before-and-after comparison.
  • Compared outcomes in districts implementing the program versus non-program districts.
  • Focused on identifying changes in neonatal mortality and intermediate indicators.

Main Results:

  • The program significantly increased clean home deliveries and prenatal visits.
  • No statistically significant reduction in neonatal mortality was observed.
  • Improvements in institutional or professional-attended deliveries were not evident.

Conclusions:

  • While the Community-Based Neonatal Care Package positively influenced some intermediate outcomes, it did not achieve its primary goal of reducing neonatal mortality.
  • Supply-side constraints may have limited the program's effectiveness.
  • The role of Female Community Health Volunteers warrants a broader examination.