Various plans and policies aimed at reducing infant mortality rate in Palpa have failed to bear results with the number of infant deaths this fiscal year surpassing that of preceding years.

In the fiscal year 2020-21, 22 infants in the district died within 28 days of their birth. According to the data of the District Health Office, 4,601 children were born in the fiscal year 2020-21.

In the fiscal year 2019-20, out of 5,322 new births, 11 infants died within 28 days while nine out of 5,637 infants died within 28 days in the fiscal year 2018-19, the record of the District Health Office showed.

According to the District Health Office in Palpa, the number of infantile deaths has increased across the district in the last four years despite several programmes implemented at the local and district levels to save mothers and babies.

The government has been running the Suaahara Programme, one of the initiatives of the federal government that aims to improve the health and nutritional status of women and children to lower maternal and infant deaths, in Palpa for the last six years. The programme spends Rs 10 to 15 million every year for safe motherhood and infant care. Postpartum women and their newborns get nutritious food among other things for 1,000 days after delivery under the programme.

However, such efforts have not been effective mostly because the budget allocated for the government programmes have not been utilised properly, according to Chitrabali Ram Suwal, a civil society leader in Tansen, the district headquarters of Palpa.

“Every year, the District Health Office in Palpa and other organisations spend millions on safe motherhood and child care programmes. But the allocated budget is misused,” said Suwal. “The budget is allocated to reduce maternal and infant deaths, eliminate malnutrition and increase food security and nutrition level in both mothers and their children. But the ones responsible for the implementation of the programmes use the money on conducting inspections, training, seminars and on allowances, which do not benefit the target group.”

Om Prakash Panthi, information officer at the District Health Office in Palpa, agrees that the programmes have failed to bear results in the district.

“The number of infantile deaths has been increasing in Palpa over the years. This brings the effectiveness of various programmes introduced to reduce infant mortality rate and boost maternal health into question,” Panthi said.

According to him, the District Health Office spent over Rs 3 million last year on providing training on safe motherhood to health workers at local health posts and hospitals.

“We are conducting various programmes to curb infant mortality rate and promote safe motherhood and child care,” said Panthi. “The training and workshops were conducted to educate health workers on safe motherhood policies but the effort failed to show results at the grassroots level.”

Bishnumaya Gaha, a health volunteer of Phek in Ribdikot Rural Municipality, believes that if the country is to achieve success in eliminating infant and maternal mortality rate, it must first eradicate child marriages which are still prevalent in the rural areas.

“One of the contributing factors to the rising infant mortality rate in Palpa is the authorities’ failure to stem child marriages, especially in the rural parts of the district,” said Gaha. “Child marriages are still prevalent in the district. When teenagers become mothers, it affects the overall health of the mother and her newborn.”

According to her, rather than conducting training and seminars for the health workers, the authorities should launch awareness programmes at the local level that will reach people’s doorsteps.

“If infant mortality rate is to be improved, it is imperative to sensitise the local people about the repercussions of child marriage and its long-lasting impact on the mother and the child’s health,” said Gaha.

Sunil Adhikari, chief at the Health Unit of Ribdikot Rural Municipality, says children of teenage mothers die within a few days of their birth.

“The health condition of mothers also gets worse after delivery. That’s why awareness programmes should be launched at the community level to save both mothers and children,” Adhikari said.

Purbakhola Rural Municipality says it has been taking active steps towards reducing maternal and infant mortality rate by conducting regular health check-ups of pregnant and postpartum women as well as infants, according to Mohan Dhakal, chief at the Health Unit of the rural municipality.

According to the National Demographic Health Survey of 2016, of every 1,000 live births, 21 babies die within a month in Nepal. The survey also shows that for every 100,000 births, 229 women die during or after childbirth. Nepal had previously reduced the maternal mortality rate from 539 in 1996 to 239 in 2016—for which the country received the Millennium Development Goal award.