Since 2022, USAID and partners have been working to prevent infant mortality in developing countries. Chlorhexidine, a chemical element that comes in gel and liquid form, could be a potential solution to infant mortality. Typically used to disinfect human skin and sterilize surgical instruments in hospitals, the substance can also help protect the umbilical stumps of newborns to prevent deadly infections. USAID’s Chlorhexidine “Navi” Care Program applies this technique in rural Nepal. Furthermore, the miracle gel has decreased newborn deaths by 24% and newborn infections by 68% in Nepal.

Susceptibility to Infant Mortality in Nepal

Rural and low-income communities in Nepal are susceptible to high rates of infant mortality and infections that arise from traditional home birthing practices. Mothers sometimes cut umbilical cords with unsanitized house tools and treat the stump with turmeric as an antiseptic. However, these methods can be harmful as evidenced by a neonatal mortality rate of 23 per 1,000 live births in 2020. Furthermore, about 70% of infant mortality cases in Nepal tend to occur within the first year of the infant’s life.

USAID’s “Navi” Care Program

The Navi Care Program began in October 2011. With a budget of $3.9 million, the program was able to expand from 49 operating districts to cover all 75 districts in Nepal by 2014, according to USAID. The Navi Care Program helps in training nurses and healthcare practitioners to use chlorhexidine gel. The program also works to spread awareness about the miracle gel and supports the Ministry of Health and Population in Nepal to integrate it into the newborn and maternal healthcare systems.

Raising Awareness Through SBCC

As remarkable as the miracle gel is in terms of reducing infant mortality, not enough people in Nepal know about the solution and how they can access it. A social behavior change campaign (SBCC) started in 2015 works to ensure that locals learn about chlorhexidine. The campaign spreads information about the usefulness and affordability of the miracle gel through local and national radio and broadcast television.

Monitoring and Evaluating

In 2017, the Navi Care Program prevented nearly 9,600 newborn deaths in Nepal. With the help of the JSI Research & Training Institute, the USAID Navi Care Program has set up mechanisms to document and monitor the impact of the program. Chlorhexidine reports have been integrated into the pre-existing government health management information system (HMIS) and logistics management information system (LMIS). In addition, JSI wanted to monitor the process of program implementation. It uses a comprehensive mechanical system to gather external research and surveys from local women. JSI conducted telephone calls and in-person visits to meet healthcare professionals, pregnant women in their last leg of pregnancy and women with infants under the age of six months. Through this, they have been able to gather feedback and identify gaps in the implementation of the Navi Care Program in Nepal.

The Navi Care Program and miracle gel have become increasingly successful in Nepal and can save millions of lives in other countries too. The discovery and implementation of medical solutions can have a revolutionary impact on all communities, especially those that are susceptible to illnesses and infant mortality.

– Samyudha Rajesh
Photo: Flickr