Where to invest in neonatal survival programs in Nepal? A modelling study using Lives Saved Tool through scaling key interventions

Nepal must prioritize highly effective interventions: neonatal resuscitation, breastfeeding, management of neonatal sepsis and case management of premature babies to accelerate progress towards the NENAP target. Our analysis indicates that achieving the specific coverage targets of 35 NENAP interventions could reduce the NMR to 14 per 1,000 live births which fall short of the NENAP targets of reducing NMR to 11 per 1,000 live births by 2035. Strengthening special newborn care unit (SNCU) in line with WHO standard is critical to improving the quality of care for small and sick newborns (SSNB) in health facilities. While strengthening newborn resuscitation and SNCU services will substantially reduce NMR, attaining the NENAP targets will ultimately require comprehensive health system reforms and effective coverage of other maternal and newborn interventions.