A planned six-day training for medical officers serving in all district hospitals across the country has been halted indefinitely. These doctors were supposed to get training to save neonates either born in hospitals where they work or brought in for treatment.

Similarly, hundreds of nurses serving in district hospitals who were all set to get a 15-day neonatal care training in the third trimester of the ongoing fiscal year will not receive any training this year.

Health authorities had also planned a four-day orientation for these doctors and nurses on neonatal deaths and measures needed to prevent it. However, all these programmes have been suspended indefinitely for the same reason–the new Donald Trump administration’s abrupt decision to suspend nearly all US assistance worldwide for 90 days, with immediate effect.

The budget of several other health programmes, including the ‘outbreak investigation training’ for doctors, has also been suspended, further disrupting essential health initiatives.

“Achievements made over the years through huge investments in neonatal care could be jeopardised by this abrupt budget cut,” said Dr Shyam Raj Upreti, former director general of the Department of Health Services. “The suspension of crucial programmes is a serious blow to our efforts to reduce neonatal deaths, and we are already lagging behind our targets.”

Neonatal means newborns or the first 28 days of life. It is estimated that over 2,000 neonates die every year throughout the country. According to data provided by the Health Information Management System under the Department of Health Services, 1,377 neonates died in the last fiscal year. Officials acknowledge that the actual number of deaths could be far higher than reported, as the data only covers district hospitals and some private hospitals.

Child health experts say infection, birth asphyxia, premature birth, hypothermia, low birth weight, poor pregnancy health, and poor postpartum care among others are the leading causes of neonatal deaths in Nepal.

“Doctors and nurses would have received essential newborn care training had the programme not been halted,” said Nisha Joshi, a public health officer at the Family Welfare Division. “We are not in a position to fund the training from the government’s budget, as we are already midway through the fiscal year.”

The Nepal Demographic and Health Survey-2022 shows that 21 neonates die in every 1,000 live births. The progress has been stagnant since 2016. The government’s target for Sustainable Development Goals is to reduce neonatal mortality to 12 deaths per every 1,000 live births by 2030.

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

Experts blamed a lack of neonatal units, trained human resources, and quality services for stagnant progress in neonatal health. Along with trained human resources, infrastructures and quality services, deaths of neonates are also linked to the antenatal care visit of pregnant women, access to health facilities, timely referral system and others, experts say.

“A lot of investments and micro planning are required to make further progress,” said Upreti. “Authorities must explore alternative funding sources or allocate additional government resources to continue the programmes.”

The World Health Organisation says most neonatal deaths occur during the first week of life, and about one million die within the first 24 hours across the world.