Nepal has successfully achieved the Millennium Development Goals (MDGs) 4 to “Reduce Child Mortality” under infant mortality rate with a target of 36 per 1000 live birth between the years 1990 to 2015. During the MDG’s tremendous growth and changes has been seen in the live birth rate. In the year 1990 the number of infant mortality was 98.44 per 1000 live birth whereas in 2000, it was 60.04 per 1000 live birth. Despite substantial decrease in other health areas the number of infant deaths is decreasing, with 29.22 per 1000 live birth in 2015 and only 27.9 per 1000 live birth in 2017. Concerning the serious issue of the Sustainable Development Goal (SDGs) 3, “Good Health and Well Being” is being practiced in the context of Nepal starting from 2016, to go until 2030, with a target to reduce preventable death of less than 1 percent of new born babies by 2030.
Infant mortality rate is outrageous among the poorer families, uneducated mothers, living under disadvantages of the society and extremely low income. Especially in the rural areas, girls get married between 18 and 24 years and give birth to babies at a tender age. The lack of knowledge regarding maternal and infant health care ultimately leads to hazardous health issues in a new born baby or causes death of infant child. A significant increase in the number of health post/clinic and birthing center is of tremendous help but insufficient prerequisites and medications leads to infant mortality.
According to Nepal Health Sector Program, in 2015 there were 1134 birthing centers in Nepal. But the fact is that many government birthing centers are not functioning properly and lacking equipment, general medicine, with limited medical facilities and proper vaccination and poor service quality with lack of accessibility. Birthing centers lack Auxiliary Nurse Midwife (ANM), Birth Attendants and Health Assistants (HA), who could provide better health facilities during emergency, delivery and provide basic knowledge to mothers regarding the health care of their new born babies.
Inadequate facilities and medical practitioners’ in the birthing centers leave no option for pregnant women and they travel to the district hospital or Kathmandu to get enhanced amenities. Moreover, families’ break down with the travel, accommodation, food, hospital and medical expenses during delivery in a district hospital and, therefore, prefer to give birth at home. Approximately 90% of the deliveries in rural areas takes place at home in extremely poor and unhygienic conditions and newborn infants are wrapped in unsanitized clothes. This clearly shows the vulnerability of people, deprived of basic birthing center facilities.
For reducing the infant mortality rate at a speedy pace, government, health sectors, community and families need to be more cautious about the health facilities provided in the rural areas. Recognizing the loopholes in the health sector is obligatory to recruit trained ANM, Birth Attendants and HAs in all the birthing centers and provide necessary amenities. Regular monitoring by the government should leave no stones unturned for this. Analyzing the problematic situation and overcoming the crucial problems Nepal could achieve its SDGs by 2030 and could save the lives of numerous infants and give them a healthy and prosperous life.