overview of perinatal and neonatal health in nepal
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Overview of Perinatal and Neonatal Health in Nepal. Dr SR Manandhar (MBBS, MD) Pediatrician , KMCTH. Introduction. Perinatal and neonatal mortality rate in Nepal is still very high - PowerPoint PPT PresentationTRANSCRIPT
Overview of Perinatal and Neonatal Health in Nepal
Dr SR Manandhar (MBBS, MD)Pediatrician, KMCTH
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
• 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 2/3rd of under 5 mortality
Trends of Infant Mortality
3432
79
64
48
1996 2001 2006 2011 20150
20
40
60
80
100
Infant Mortality Assume MDG Target Achieved Earlier MDG TargetMortality Trend Trend Assumed
• Nepal is on the track to achieve MDG Target.
• If the current trend remains, the country will achieve MDG 4 earlier….
Trends of Under 5 Mortality
54
31
118
91
61
1996 2001 2006 2011 20150
20
40
60
80
100
120
140
U5 Mortality Assume MDG Target Achieved Earlier MDG TargetU5 Mortality Trend Trend Assumed
• Nepal is on the track to achieve MDG Target.
• If the current trend remains, the country will achieve MDG 4 earlier….
Neonatal Mortality Trend
50
39
33
15
50
39
33
15
1996 2001 2006 20150
10
20
30
40
50
60NMR Trend
MDG Target to reduce Child Mortality for Nepal
T A R G E T - 5Reduce by two-thirds 1990 and 2015 the under-5 mortality rate
Indicators 1991 1996 2001 2006 2015 TARGET
IMR 108 79 64 48 34
U5MR 162 118 91 61 54
NMR 46 50 38.6 33 15
Nepal Millennium Development GoalsP R O G R E S S R E P O R T 2 0 0 5
NMR & IMR/1000 live birth (Trend)
Year IMR NMR NMR in % of IMR
1996 79 50 63%
2001 64 39 60%
2006 48 33 69%
9
Direct causes of neonatal deaths In Nepal
(Hospital based data)• Infection• Birth asphyxia/trauma• Prematurity• Hypothermia
Causes of stillbirths in Dhanusha
0
10
20
30
40
50
60
70
67
10 10 7 3 2 1
Obstetric complications
Prematurity
Unclassifiable
Maternal disease
Congenital malformations
Multiple pregnancy
Other
%
(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 (1st Sept ‘06 – 31st Aug’08)
0
5
10
15
20
25
30
35
4037
30
15
75 5
1
Birth asphyxia
Severe infection
Prematurity or Low birth weight
Hypothermia
Unclassifiable
Other
Congenital malformation
%
(Total = 671)
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 (1st Sept ‘06 – 31st Aug’08)
• 81% births at home• 50% births attended by relative or
other untrained persons• 19% each by trained person
»NDHS 2006
Delivery scenario of Nepal
THANK YOU