Newborn care: traditional practices in Nepal

About 90% of deliveries in Nepal take place at home and only 6% are attended by a skilled health worker.¹² This one was no exception. The setting was a shabby hut in a village in the plains, about 10 km away from the nearest town with a hospital. It takes about an hour and half by the fastest means available in the village—the bullock and cart. “This is not the first time we are doing this,” says the local “woman expert” in conducting labour. She smiles, “We will deliver the baby in the usual traditional way.”

The word “traditional” reverberated in my mind. I wondered what the implications might be. What if there was some complication during the delivery? And what about the care of the newborn baby? What if emergency care is needed, as in birth asphyxia, where expert help within a matter of minutes can save life?

Nepal is a country with a neonatal mortality of 39 per 1000 live births.³ In the past two decades, neonatal mortality in many poor countries has remained fairly constant despite the fall in infant mortality.⁴⁵ The direct causes of neonatal mortality in poor countries are infections, birth asphyxia, complications of prematurity, and congenital anomalies.⁶ To what extent are these explained by harmful traditional practices?