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Miracle Gel Could Save Millions Of Lives In Nepal

Miracle Gel
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

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How Chlorhexidine Reduces Neonatal Mortality

chlorhexidine reduces neonatal mortality
Although the neonatal mortality rate across the globe has been consistently decreasing, neonatal death is still common in many regions. According to the World Health Organization (WHO), annual infant deaths were at an all-time low of 4.1 million deaths in 2017, decreasing from 8.8 million in 1990. However, the death rate in Africa is over six times higher than it is in Europe, illustrating a severe disparity. As such, there is still much more that people can do to lower neonatal mortality rates. One potential solution is chlorhexidine, which reduces neonatal mortality.

How Chlorhexidine Reduces Neonatal Mortality

To combat mortality rates, Save the Children and governments in Nepal and Nigeria have implemented chlorhexidine, an antiseptic found in mouthwash. When used to clean the umbilical cord as soon as possible after birth, chlorhexidine reduces neonatal mortality by preventing infection in newborns, which is among the top drivers of neonatal deaths across the globe. Save the Children and pharmaceutical company GlaxoSmithKline (GSK) partnered to create a chlorhexidine gel to distribute in wrapped pouches. Save the Children noted that this gel “was developed to be suitable for use in high temperatures, useful in sub-Saharan Africa and [South] Asia where the risk of newborn infections is high and temperatures are hot.”

Chlorhexidine gel has become wildly popular in Nepal, where USAID created the Chlorhexidine “Navi” Care Program to distribute chlorhexidine gel. In Nepal, around half of deliveries happen at home, making newborns even more exposed to infection if they are not delivered in a clean environment. In fact, a large majority of deaths in Nepal occur within the first month of life. Moreover, infections cause half of those deaths. In Nepal, chlorhexidine has reduced neonatal mortality by 24% and decreased the rate of infections in newborns by 68%. The Chlorhexidine “Navi” Care program’s objective aims to distribute chlorhexidine gel to all 75 districts of Nepal.

The Lifesaving Effects of Chlorhexidine

Nepal is not the only country to see chlorhexidine reduce neonatal mortality rates. Nigeria, one of the most populous countries in Africa, has also seen success. Its neonatal mortality rate has dropped from 48 deaths per 1,000 births in 2003 to 37 deaths per 1,000 live births in 2013. According to many estimates, infections cause at least one-third of newborn mortalities in Nigeria. In March 2016, Nigeria created a plan to scale-up the use of chlorhexidine to lower neonatal mortality rates. If this program succeeds, it will save 55,000 infants. Although this scaling up program started slowly, the Nigerian government has committed to continuing the use of chlorhexidine to prevent infection and fatalities. To do so, it has a plan in place to help local governments achieve their goals.

Across the globe, there are large imbalances in neonatal mortality rates. Countries like Pakistan, Afghanistan and Somalia have a much higher neonatal death rate than countries such as Australia, Canada or China. In developing countries where poverty rates are higher, neonatal death skyrockets due to a lack of resources. This simple, cheap and over-the-counter chlorhexidine gel is saving lives across the globe. As chlorhexidine becomes even more accessible to every community, it is hopeful that neonatal deaths will continue to decrease.

– Hannah Kaufman
Photo: Flickr

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USAID Saves Thousands of Babies

USAID Saves Thousands of BabiesRoughly 2.76 million newborns die each year, with preventable infections causing at least 15% of those deaths. For instance, a baby’s cut umbilical cord could allow bacteria to enter their body, leading to life-threatening newborn sepsis. To avoid neonatal deaths like this, cord stump care at birth is critical, particularly in settings with poor hygiene. Thankfully, with national assistance, USAID saves thousands of babies in Nepal and other countries around the world.

There is a low-cost, easily manufactured and easily distributed life-saving solution that the World Health Organization (WHO) recognized in 1998 as a suitable antiseptic for cord care. Commonly found in mouth wash and hand sanitizers, chlorhexidine is an antiseptic gel that USAID helped produce for nations with the greatest need since 2002. Nepal was the first nation to adopt chlorhexidine on a large scale. USAID’s efforts, as well as cooperation with the Government of Nepal and its private sector, are responsible for lowering the infant mortality rate significantly. USAID saves thousands of babies around the world.

Chlorhexidine “Navi” Care Program

USAID’s Chlorhexidine “Navi” Care Program, implemented by John Snow Inc. (JSI), provides technical assistance to the Government of Nepal to scale up the use of chlorhexidine through resources and education. The six-year, $3.9 million program had two phases. The first phase occurred from October 2011 to September 2014 in 49 out of 75 of Nepal’s districts. Phase two started in October 2014 and brought chlorhexidine to all districts. The program found funding as a part of USAID’s “Saving Lives at Birth: A Grand Challenge for Development.”

The Nepali government strongly advocated for this scale-up. The administration incorporated single-use chlorhexidine tubes into its maternal and child health packages. In addition, it also trained health care workers for use of the antiseptic. Nurses began to use chlorhexidine at birthing centers across the country. They apply the antiseptic to the umbilical stump immediately after the cut. Its use in Nepal decreased newborn infections by 68% and decreased newborn deaths by 24%. Chlorhexidine for cord care thus became an integral part of maternal and infant health programs. Through the implementation of its new programs like this, USAID saves thousands of babies.

According to the Bill & Melinda Gates Foundation, Dalberg Global Development Advisors and the Boston Consulting Group, it usually takes more than a decade for global health innovations to develop in low and middle-income nations. In Nepal, it took around five years.

The success of USAID’s Navi Care Program is attributed to its partnering with the Government of Nepal and various organizations. USAID’s partners include MoHP, Save the Children, Plan International, Health For Life (USAID), UNICEF, One Heart Worldwide and PSI. Future initiatives should replicate USAID’s coordinated effort due to this program’s monumental success.

Nepal’s Success Serves as a Model for Others

Other nations have taken notice of Nepal’s health improvements and how USAID saves thousands of babies. Many nations sent their leaders and officials to speak with those who worked on the program to expand the use of chlorhexidine in their own countries. Following Nepal as a model, these nations have planned trials with the antiseptic gel. All program-related materials are public, supporting the global trend. As a result, Nigeria, Bangladesh, Pakistan and the Democratic Republic of Congo have begun the process of scaling up chlorhexidine to reduce newborn death rates. In particular, Nigeria has made substantial progress.

USAID’s efforts to lower infant mortality rates yielded fruitful results from a single and simple solution. As a result, it inspired efficient innovation elsewhere. This program was a tremendous global success, as USAID saves thousands of babies and makes the world a healthier place. USAID’s programs will hopefully continue to work with the governments and organizations in low- and middle-income nations to achieve the optimal adoption of healthcare initiatives.

– Mia McKnight
Photo: Wikimedia Commons