Peter Oyloe (
Leela Khanal is project director of the Chlorhexidine Navi Care Program, JSI Research and Training Institute, in Kathmandu.
Health Aff (Millwood). 2017 Nov;36(11):1973-1978. doi: 10.1377/hlthaff.2017.0548.
Approximately 40 percent of all newborn deaths in Nepal are attributable to neonatal infections. A randomized controlled trial conducted in Nepal in the period 2002-05 on the application of a solution of the disinfectant chlorhexidine to umbilical cord stumps of newborns showed a reduced risk of infections and death. In response to these results, the Government of Nepal and various partners mobilized to deliver this simple, low-cost intervention on a national scale. We describe the design, development, and maturation of a partnership among the government, technical assistance agencies, and a local pharmaceutical company to create a suitable, commercially available gel product to reduce newborn infections. Essential contributors to the partnership's effectiveness included having a for-profit pharmaceutical company as a fully engaged partner; having responsive, flexible relationships among the partners that evolved over time; and paying attention to competition within the private sector. A less formalized arrangement among partners allowed them to build trust in each other over time. Government stewardship of the program throughout the scale-up process ensured that policy and systems integration were aligned as the program matured.
尼泊尔约 40%的新生儿死亡可归因于新生儿感染。2002-2005 年，尼泊尔开展了一项随机对照试验，研究将消毒剂洗必泰溶液应用于新生儿脐带残端，结果显示可降低感染和死亡风险。针对这些结果，尼泊尔政府和多个合作伙伴共同努力，在全国范围内推广这一简单、低成本的干预措施。我们描述了政府、技术援助机构和当地制药公司之间建立伙伴关系，以创建合适的、可商业化的凝胶产品来减少新生儿感染的设计、开发和成熟过程。该伙伴关系的有效性的关键因素包括让一家营利性制药公司作为完全参与的合作伙伴；合作伙伴之间具有响应性和灵活性的关系，并随着时间的推移不断发展；以及关注私营部门内部的竞争。合作伙伴之间较为非正式的安排使他们能够随着时间的推移建立互信。政府在整个扩大规模过程中对该计划的管理确保了政策和系统的整合与计划的成熟度保持一致。
