Nepal is on track to achieve the Millennium Development Goal of reducing under-five mortality by two-thirds. However, neonatal mortality now accounts for 54 per cent of under-five mortality. Therefore, activities aimed at reducing newborn death are urgent.
Routine immunisation coverage was 84 per cent in 2007, a decline of nine percentage points over 2006. Nepal was declared free of maternal and neonatal tetanus in December 2005, however 13 confirmed neonatal tetanus cases were reported by October 2007. The measles campaign conducted in 2004/05 has brought the level of measles cases down to controllable levels; 14 confirmed measles cases were reported by October 2007.
Community-based integrated management of childhood illnesses (IMCI) has been expanded to 48 districts. The incidence of severe pneumonia per 1,000 under-fives has declined to 4.9 cases.
• Raise awareness of the importance of full immunisation with mothers of under-one year olds and mothers of socially excluded children. Support planning workshops at health facilities, train local-level health workers and
By 2010, young children, with a particular focus on the most disadvantaged groups, will have increased access to immunisation services and to high quality, state-of-the-art newborn services, while mothers will have an increased awareness of the importance of these services. Some 90 per cent mothers of under-ones and 85 per cent of mothers from socially excluded groups will be aware of the importance of immunisation and will complete the full schedule. Districts will collect disaggregated immunisation data, for targeting the unreached. Nepal will maintain zero status for indigenous wild polio cases, and will control measles in all 75 districts.
A new Community-based integrated management of childhood illnesses package, that includes newborn interventions, will be implemented, and Female Community Health Volunteers in 15 districts will have the knowledge and skills to manage newborn healthcare according to the revised package. More districts