Background: The World Health Organization recommends initiation of breastfeeding within 1 hour of birth and exclusive breastfeeding up to 6 months of age. Infant feeding practices, including suboptimal breastfeeding practices, are associated with stunting. Rate of stunting was highest in the Mid-western region and lowest in the Eastern region of Nepal. This study aimed to assess the breastfeeding practices in these two regions, as well as to identify factors associated with partial breastfeeding. Methods: We conducted a health facility-based cross-sectional study in the Mid-western and Eastern regions of Nepal from December 2017 to May 2018. Investigators administered a pre-tested questionnaire among consecutive 574 mother-infant dyads at different levels of health facilities. We dichotomized the breastfeeding pattern to partial breastfeeding and full (exclusive or predominant) breastfeeding. We conducted multivariable logistic regression to identify factors associated with partial breastfeeding within 6 months of age. Results: There were 574 infants included in the study, all of which received at least some breastfeeding. Only 23.2% of infants were exclusively breastfed until 6 months, with 28.2% predominantly breastfed and 48.6% partially breastfed. Partial breastfeeding rate was 52.3% in the Mid-western region and 44.4% in the Eastern region. Breastfeeding was initiated within an hour from birth in 67.2% of infants. One-quarter of infants were given pre-lacteal feed, honey being the commonest. Knowledge of the recommended duration of exclusive breastfeeding was inadequate in 16, and 65% of mothers reported breastfeeding problems in the first 6 months. Firstborn and low birth weight infants had a significantly higher rate of partial breastfeeding. Partial breastfeeding was also higher when infants were not breastfed within 1 hour from birth, mothers reported having breastfeeding-related problems or had inadequate knowledge of the duration of exclusive breastfeeding. Conclusion: Nearly half of the infants were fully breastfed at 6 months of age in Nepal. The rate of partial breastfeeding was higher with inadequate knowledge on duration of exclusive breastfeeding or late initiation of breastfeeding or perceived breastfeeding problems. Hence, programs should address knowledge and practice gaps in breastfeeding practices, particularly among mothers of low birth weight and firstborn infants.

Introduction: Disrespect and abuse of women during maternity care in health institutions can significantly impact women’s willingness to seek out life-saving maternity care however; evidence suggests prevailing disrespectful maternity care worldwide. This study aims to identify perceived disrespect and abuse during labor and delivery among postnatal women delivering at Bheri Hospital, Nepal. Methods: A cross-sectional study was conducted among 422 purposively selected women admitted in the postnatal ward of Bheri Hospital, Nepal, from February to March 2020. Face-to-face interview was conducted for data collection after obtaining informed written consent. A semi- structured questionnaire consisting of demographic information and a pre-validated Respectful Maternity Care (RMC) tool was used. The information was then checked, coded, and entered in SPSS for descriptive and inferential analysis. Results: In this study, most of the participant perceived high respectful maternity care which included high friendly care, high abuse free care and high discrimination free care however only half of the participants experienced timely care. As compared to Highly-Priviledged ethnic group, Madhesi/ dalit and other minority groups reported of experiencing low respectful maternity care. Also, those who had monthly income of more than NRs. 20000 and who had more than two living children were found to have experienced low respectful care as compared to those with lesser income and less than two children respectively. Conclusion: This study concludes that though overall respectful maternity care is high, low timely care has been reported as compared to other components of Respectful maternity care i.e. friendly care, abuse-free care, and non- discriminatory care. Delayed care provided may negatively impact the delivering women to use the services in future or refer others for the same. Thus, appropriate interventions to provide timely care to delivering women must be instituted.

Background: Nepal’s diverse geography creates significant challenges for healthcare accessibility, particularly for neonatal care. Rural areas, especially in the mountainous regions, face severe healthcare gaps due to isolation, inadequate infrastructure, and a shortage of skilled staff. Strengthening healthcare in these underserved regions is essential to reducing neonatal mortality. Methods: A comprehensive literature search identified studies on neonatal mortality and interventions, particularly Helping Babies Breathe (HBB), analyzed using a narrative synthesis approach. The review examined disparities in neonatal health outcomes, regional differences, and barriers to healthcare access. Findings: The review identified key themes related to healthcare disparities, neonatal mortality, and birth outcomes in Nepal's remote regions. Geographical isolation, inadequate healthcare infrastructure, and cultural barriers contribute to persistently high neonatal mortality, particularly in mountainous areas such as Jumla and Dolpa, where rates exceed 60 per 1,000 live births. HBB has shown a significant impact, reducing neonatal mortality by up to 60% when effectively implemented. However, infrastructural gaps, lack of emergency transport, and the uneven distribution of skilled birth attendants (SBAs) remain critical challenges. Addressing these disparities requires expanded training, increased availability of neonatal resuscitation equipment, and culturally sensitive healthcare strategies. Recommendations: Future research should explore sustainable neonatal resuscitation training, telemedicine support, and emergency referral systems to improve neonatal survival in remote Nepal. Further studies on healthcare infrastructure gaps and policy-driven interventions are needed to enhance maternal and newborn care. Conclusions: While HBB and other neonatal interventions have demonstrated success in reducing neonatal mortality, their impact is limited by persistent disparities in healthcare infrastructure, workforce availability, and geographic inaccessibility. To achieve sustainable reductions in neonatal mortality, a multi-faceted approach combining expanded SBA training, improved emergency healthcare infrastructure, and community-based interventions is essential.

Perinatal asphyxia is a common cause of neonatal morbidity and mortality especially in low resource developing countries like Nepal. Early intervention and appropriate management is very crucial for preventing mortality and long-term sequalae. This study aims to understand the severity of perinatal asphyxia and its correlation with umbilical cord blood pH. This hospital-based prospective study aimed to assess the correlation between cord blood pH and the severity of perinatal asphyxia, specifically its association with hypoxic-ischemic encephalopathy (HIE) and early neonatal outcomes. A total of 56 neonates out of which 40 were term and 16 were preterm were enrolled, and the data were analyzed using SPSS. Results showed that lower cord blood pH was significantly associated with the severity of HIE (P < .01). Neonates without HIE had a mean pH of 7.24, while those with severe HIE had a mean pH of 6.8. The analysis reveals a statistically significant negative correlation between Cord blood PH and HIE with a Pearson correlation coefficient of −0.634. A significant relationship was found between birth asphyxia, low birth weight, preterm gestation, severe HIE. Mortality occurred in 7% of the neonates, all within the severe HIE group. This study highlights the critical role of cord blood pH in predicting neonatal outcomes, emphasizing its potential as an early indicator for intervention in perinatal asphyxia.

Background: Nepal’s diverse geography creates significant challenges for healthcare accessibility, particularly for neonatal care. Rural areas, especially in the mountainous regions, face severe healthcare gaps due to isolation, inadequate infrastructure, and a shortage of skilled staff. Strengthening healthcare in these underserved regions is essential to reducing neonatal mortality. Helping Babies Breathe (HBB) is a neonatal resuscitation training program designed to reduce neonatal mortality due to birth asphyxia in low-resource settings. Methods: A comprehensive literature search identified studies on neonatal mortality and interventions, particularly HBB, which were analyzed using a narrative synthesis approach. This review examines disparities in neonatal health outcomes, regional differences, and barriers to healthcare access. Findings: This review identifies key themes related to healthcare disparities, neonatal mortality, and birth outcomes in Nepal’s remote regions. Geographical isolation, inadequate healthcare infrastructure, and cultural barriers contribute to persistently high neonatal mortality, particularly in mountainous areas such as Jumla and Dolpa, where rates exceed 60 per 1000 live births. HBB has shown a significant impact, reducing neonatal mortality by up to 60% when effectively implemented. However, infrastructural gaps, lack of emergency transport, and the uneven distribution of skilled birth attendants (SBAs) remain critical challenges. Addressing these disparities requires expanded training, increased availability of neonatal resuscitation equipment, and culturally sensitive healthcare strategies.