Kain Victoria Jane, Dhungana Ranjan, Dhungana Animesh
School of Nursing and Midwifery, Brisbane South Campus, Griffith University, 170 Kessels Road, Brisbane, QLD 4111, Australia.
Safa Sunaulo Nepal, Kathmandu 44600, Nepal.
Pediatr Rep. 2025 Apr 17;17(2):48. doi: 10.3390/pediatric17020048.
Nepal's diverse geography creates significant challenges for healthcare accessibility, particularly for neonatal care. Rural areas, especially in the mountainous regions, face severe healthcare gaps due to isolation, inadequate infrastructure, and a shortage of skilled staff. Strengthening healthcare in these underserved regions is essential to reducing neonatal mortality. Helping Babies Breathe (HBB) is a neonatal resuscitation training program designed to reduce neonatal mortality due to birth asphyxia in low-resource settings.
A comprehensive literature search identified studies on neonatal mortality and interventions, particularly HBB, which were analyzed using a narrative synthesis approach. This review examines disparities in neonatal health outcomes, regional differences, and barriers to healthcare access.
This review identifies key themes related to healthcare disparities, neonatal mortality, and birth outcomes in Nepal's remote regions. Geographical isolation, inadequate healthcare infrastructure, and cultural barriers contribute to persistently high neonatal mortality, particularly in mountainous areas such as Jumla and Dolpa, where rates exceed 60 per 1000 live births. HBB has shown a significant impact, reducing neonatal mortality by up to 60% when effectively implemented. However, infrastructural gaps, lack of emergency transport, and the uneven distribution of skilled birth attendants (SBAs) remain critical challenges. Addressing these disparities requires expanded training, increased availability of neonatal resuscitation equipment, and culturally sensitive healthcare strategies.
尼泊尔多样的地理环境给医疗服务的可及性带来了重大挑战，尤其是新生儿护理方面。农村地区，特别是山区，由于地处偏远、基础设施不足以及缺乏技术人员，面临着严重的医疗服务差距。加强这些服务不足地区的医疗保健对于降低新生儿死亡率至关重要。“帮助婴儿呼吸”（HBB）是一项新生儿复苏培训计划，旨在降低资源匮乏地区因出生窒息导致的新生儿死亡率。
通过全面的文献检索，确定了关于新生儿死亡率和干预措施的研究，特别是HBB，采用叙述性综合方法进行分析。本综述考察了新生儿健康结果的差异、地区差异以及医疗服务可及性的障碍。
本综述确定了与尼泊尔偏远地区医疗保健差距、新生儿死亡率和出生结局相关的关键主题。地理隔离、医疗基础设施不足和文化障碍导致新生儿死亡率持续居高不下，特别是在朱木拉和多尔帕等山区，每1000例活产的死亡率超过60例。HBB已显示出显著影响，有效实施时可将新生儿死亡率降低多达60%。然而，基础设施差距、缺乏紧急运输以及熟练助产士（SBA）分布不均仍然是关键挑战。解决这些差距需要扩大培训、增加新生儿复苏设备的供应以及采用对文化敏感的医疗保健策略。
