Brief background of CB-NCP
Over the past decade, the country has had success in reduction of under five mortality due to the implementation of community-based child health programming at scale throughout the country, particularly Vitamin A and Community Based Integrated Management of Childhood Illnesses (CB-IMCI) services provided by Female Community Health Volunteers (FCHV).
The program goal is to improve the heath and survival of newborn babies and aims at preventing and managing newborn infection, hypothermia & LBW babies, post delivery asphyxia and in developing an effective system of referral of sick newborns. CB-NCP program has introduced FCHV as the main service provider at community for newborn care and services.
According to the global statistics and Hospital based data, the major causes of neonatal death in Nepal are infection, birth asphyxia, preterm birth, and hypothermia. Three-quarters of all neonatal deaths occur during the first week of life, 25–45% in the first 24 hours. This is also the period when most maternal deaths occur. Neonatal mortality rate is high as 81% of the delivery occurs at home, 19 % by SBA, 19% by TBA and 50% by untrained person. The underlying factor for these burdens of death is the gap in the continuum of care from mother- newborn and child, lack of care from household to hospital, low institutional deliveries, lack of skilled care at pregnancy, delivery and post-natal period, inadequate access to and utilization of quality care and poor maternal nutrition & micro-nutrient deficiencies.
Nepal Demographic Health Survey 2006, estimates the Neonatal mortality to be 33 death per 1000 live births. Newborn death constitutes 54 percent of under five mortality (U5MR) and 69 percent of infant mortality respectively. Therefore, it is an urgent priority of Ministry of Health and Population, to reduce under five mortality rate by two third between 1990 and 2015 to achieve the millennium development goal 4.
As an affirmative action against reducing the neonatal death, Ministry of Health and Population policy and programs have incorporated neonatal health as an integral component of safe motherhood efforts. National Neonatal Health Strategy was also endorsed in 2004, to improve the health and survival of newborn babies. Based on the strategies guided by the National Neonatal Health Strategy, Community Based Newborn Care Program (CB-NCP) has been developed in Nepal. The program has been envisioned and designed for integration into the Safe motherhood and Child health program. Consequently this package was endorsed by the MoHP on 21st December, 2007 for piloting in 10 districts of Nepal by the end of 2008. So it is implemented in 10 districts of the country viz. Dhunkuta, Sunsari and Morang at Eastern Region, Kavre, Parsa and Chitwan at Central Region, Palpa at Western Region, Dang and Bardiya at Mid Western Region and Doti at Far Western Region. This program pinpoints on the vulnerable neonatal period 0-28 days of newborn. Based on recommendation and lesson learn of these 10 pilot districts, CB-NCP will be gradually scaled up through out the country.
- To improve the health and survival of newborn babies
- To prevent and manage newborn infection
- To prevent and manage hypothermia & LBW babies
- To manage post delivery asphyxia
- To develop an effective system of referral of sick newborns
- Promotion of institutional delivery and clean delivery practices in case of home deliveries
- Postnatal care
- Community case management of pneumonia/PSBI
- Care of low birth weight newborns
- Prevention of hypothermia
- Recognition of asphyxia, initial stimulation and resuscitation of newborns