In a bid to avoid referring critically ailing babies to other hospitals, Kanti Children’s Hospital has started expanding neonatal intensive care unit beds and paediatric intensive care unit beds.

Officials hope the move will provide huge relief to some parents of ailing small children, who generally do not get other options except taking their babies to private centres to save them.

“We are expanding the neonatal intensive care unit beds to 20 from the existing 13 and paediatric intensive care unit beds to 15 from the existing 12 in our hospital,” said Dr Yuba Nidhi Basaula, director at the hospital. “We are also setting up a five-bed kangaroo mother care unit at the hospital.”

The Kanti Children’s Hospital is the primary centre for paediatric care in the country. Health workers serving throughout the country refer seriously ailing children to the hospital for consultant care. Poor people who cannot afford private care also seek treatment at the hospital. However, due to lack of sufficient beds, especially neonatal intensive care unit beds and paediatric intensive care unit beds, doctors at the hospital refer dozens of children to other hospitals every day.

Parents of the ailing children who cannot afford private care are forced to take their babies home without treatment, which is one of the major reasons for high neonatal deaths in the country.

Kangaroo mother care, which involves skin-to-skin contact and exclusive breastfeeding, significantly improves a premature or low birthweight baby’s chances of survival, according to the World Health Organisation.

Starting kangaroo mother care immediately after birth has the potential to save up to 150,000 more lives each year, compared with the current recommendation of starting it only once a baby is stable.

Mother-Newborn Intensive Care Units (ICUs) will be critical to support the mother, or a surrogate, in providing this immediate, ongoing skin-to-skin contact from birth, the UN health body said in its report.

According to the results of the immediate kangaroo mother care study kangaroo mother care is already known to be effective, reducing mortality by 40 percent among hospitalised infants with a birth weight less than 2.0 kg when started once they are clinically stable. However, this important new study provides new evidence to show a further 25 percent reduction when it is initiated immediately after birth, either with the mother or a surrogate.

A recent report of the Nepal Demographic and Health Survey-2022 carried out by the Ministry of Health and Population between January 5 and June 22 this year with technical as well as financial support from the United States Agency for International Development shows that neonatal deaths have not declined in the last five years.

Report of the nationwide study shows that still 21 children in every 1,000 live births die within a month.

The figure was the same in 2016.

The government’s target for Sustainable Development Goals was to reduce the neonatal mortality rate to 16 deaths per every 1,000 live births, by 2022.

SDGs, a follow-up on the Millennium Development Goals (MDGs), aims at ending poverty and hunger and all forms of inequality in the world by 2030, and Nepal has committed to meeting the goals.

The report shows that under-five mortality rate has declined to 33 from 39 in 2016 and infant mortality rate to 28 from 32 in 2016, in every 1,000 live births.

“All ongoing neonatal deaths will not stop from expansion of a few neonatal intensive care unit beds and paediatric intensive care unit beds in our hospital,” said Basaula. “But something is better than nothing and other hospitals should also expand the facilities.”

The government had targeted to reduce the under-five mortality rate to 27 and infant mortality rate to 20 in every 1,000 live births by 2022 to meet the SDG targets.

Eighty-five percent of all deaths among children under age of five in Nepal take place before a child’s first birthday, with 64 percent occurring during the first month of life, according to the study.

Although both under-five and infant mortality rates have declined compared to 2016 but not at the pace the country has committed to achieve, officials at the Ministry of Health and Population.

“This report suggests that all agencies concerned and stakeholders have to do more to achieve the targets,”said Lila Bikram Thapa, chief of the nutrition section at the Family Welfare Division under the Department of Health Services.

Hypothermia, infection, low birth weight, premature birth, abnormal birth asphyxia are among the leading causes of neonatal deaths, doctors say.

The section has been running programmes on newborn care, kangaroo care, exclusive breastfeeding, infection prevention, chlorhexidine for umbilical cord care and free neonatal care, among others, to lower child mortality.