DHULIKHEL, Nepal - Sangita Shrestha desperately waits in a hospital bed to see the baby girl she has just delivered. In the next room, a nurse applies a gel to the stump of the newborn's umbilical cord, wraps her in cloth and places her in a cot next to her mother. "I was naturally worried and getting impatient. Now I am happy to know that my daughter is safe from infection,"18-year-old Shrestha said at the Dhulikhel hospital, 30 km (19 miles) east of Kathmandu, Nepal's capital.
The baby was briefly separated from her mother when an antiseptic gel known as "Navi Malam", or chlorhexidine, was applied to avoid umbilical cord infection - a main cause of newborn deaths in the impoverished Himalayan nation.
Made by local firm Lomus Pharmaceuticals and backed by the government, the US aid agency and other donors, the gel was introduced in 2011 in hospitals across Nepal and has helped to reduce the number of babies dying from umbilical cord infection.
Trials have shown a 23 per cent drop in newborn deaths due to infection since the gel was introduced, according to USAID.
Nepal was the first country to adopt chlorhexidine for newborn cord care, with Nigeria and Madagascar in the process of implementing it in their health programmes. "The United States will work to bring the chlorhexidine to the world," Rajiv Shah, the head of USAID, said during a visit to Nepal last month while presenting the government with the"Pioneers Prize" for leading the cord care programme.
TABOOS AND HURDLES
Nepal emerged from a decade-long civil war in 2006 and political infighting since then has deepened the economic woes of its 27 million people, a quarter of whom live on less than US$1.25 (S$1.58) a day. The crisis has hit development efforts, driving thousands of young people to seek work abroad.
Experts say Nepal's public health sector is in tatters, with fewer than 2,000 doctors and some 63,000 health workers at about 100 hospitals. Many of the country's 4,000 villages do not have a health facility and nearly two-thirds of babies are born at home without the presence of skilled midwives.
Part of the reason for the high number of newborn deaths, experts say, is because pregnancy in the majority-Hindu nation is attached with taboos that confront women with social and religious hurdles to safe delivery.
Many women cannot discuss pregnancy with anyone or take a decision to seek medical help without the family's consent.
Families often apply a paste of turmeric powder, mustard oil and ash to the newborn after cutting the umbilical cord, raising the risk of infection and death.
The newborn and the mother are considered "unholy" for 11 days after delivery and often have to live in a dark, cold and unhygienic room with the mother lacking a nutritious diet.
Government officials say many people are still unaware that they should go to health facilities and seek the assistance of skilled birth attendants. "But things are gradually changing," said Baburam Marasini, a senior Health Ministry official. "The use of the simple technology and the low-cost naval gel has made a positive impact in reducing newborn deaths due to infection."