Thapathali hospital cuts neonatal deaths by over two-thirds in five years

Neonatal deaths at Nepal's Paropakar Maternity and Women’s Hospital in Thapathali have plummeted by more than two-thirds over the past five years, a significant achievement attributed to a series of targeted improvements in newborn care. The hospital reported that neonatal deaths, which once stood at approximately eight per 1,000 live births, have now fallen to around 2.5 per 1,000.

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Due to various preventive measures taken by our hospital administration, we have been successful in reducing newborn deaths. Our success shows that neonatal deaths can be reduced further and there is still room for improvement.

Hospital director Dr. Shree Prasad Adhikari stated that preventive measures have been key to this success, emphasizing that further reductions are possible. Neonatal care focuses on the first 28 days of a baby's life. Nationally, Nepal faces a high rate of neonatal mortality, with an estimated 2,000 neonates dying annually, and a recent survey indicating a rate of 17 deaths per 1,000 live births. Data from 130 hospitals recorded 2,630 perinatal deaths in the fiscal year 2025-2026, though actual numbers may be higher.

Maternal and child health experts cite factors like infection, birth asphyxia, prematurity, hypothermia, low birth weight, poor maternal health, and a shortage of trained personnel as contributors to the high national death rates. Thapathali hospital tackled these issues by increasing its medical staff, introducing newborn screening and treatment protocols, enhancing the management of birth asphyxia and hypothermia, strengthening infection control, and promoting breastfeeding through a human milk bank.

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Eight deaths per 1,000 live births at the central hospital were alarming. We have reduced the number to 2.5, but even that is still high.

Previously, nurses at the hospital managed up to 10 sick newborns in the intensive care unit. This ratio has now improved to one nurse for every three babies, a significant step towards better care, though still short of the one-to-one ratio common in developed countries. The establishment of a human milk bank has also markedly reduced infections and complications previously seen when formula milk was used, demonstrating a comprehensive approach to improving neonatal outcomes.

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In developed countries, one nurse provides care to one patient in intensive care, but we cannot afford that level of staffing. The number of trained doctors and nurses has increased in recent years, and this has helped prevent avoidable newborn deaths.