Nepal Scale up Chlorhexidine as Part of Essential Newborn Care: Country Experience
Traditionally, most Nepali babies have been born at home—their umbilical cords often cut with dirty household tools, such as knives or sickles used in the fields. Using information handed down to them for generations, mothers would treat these freshly cut cords with turmeric, mustard oil paste or even cow dung. Infections were rampant, and many infants would die. Between 2011 and 2017, Nepal completed a nationwide scale-up of the use of chlorhexidine, a low cost antiseptic gel for cleaning umbilical cords, by integrating with ongoing maternal and neonatal health programs, under the leadership of the Child Health Division with ongoing support from JSI and other partners. The chlorhexidine coverage and compliance study (2017) has revealed that the country has achieved 59% coverage of the intervention to date, with lowest use among home births. This journal article documents how chlorhexidine was successfully integrated into Nepal's health system at scale, and provides a road map for other countries with high neonatal mortality seeking to introduce and scale up this life-saving intervention.
Authors: Bikash Lamichhane, Leela Khanal, Parashu Ram Shrestha, Penny Dawson, Samikshya Singh