Effective Coverage of Sick Child Care Services and Relationship with Under-5 Mortality Across Seven Provinces, 2022 Nepal DHS and 2021 Nepal HFS

Rachael Church, The Demographic and Health Surveys Program, Avenir Health
Kiran Acharya, NewEra

Nepal has achieved a 72% reduction in under-5 mortality rate in recent years, surpassing the average reduction of 50% globally. Between the 2006 and 2011, however, infant and neonatal deaths decreased at a much slower pace, with the neonatal mortality rate stagnating from 2006 to 2011 and again from 2016 to 2022. Child mortality may be linked to inadequate quality of care in health facilities. The World Health Organization and UNICEF recommend effective coverage measurement for assessing health system performance. Despite the importance of evaluating effective coverage, a limited number of studies have addressed sick childcare or U5MR sub-nationally. No identified studies have examined effective coverage of sick childcare by province in Nepal or the association between effective coverage and U5MR. This analysis of data from the 2022 NDHS and 2021 NHFS found that 70% of sick children in Nepal had contact with a facility of some kind for their illness. 46% of sick children received input-adjusted coverage. 22% received intervention-adjusted coverage, and only 8% received quality-adjusted coverage. No significant relationship was observed between U5MR and quality adjusted coverage. These findings indicate a need for improved availability of supplies to treat childhood illnesses and increased provider training.

Keywords: Health and Morbidity, Mortality and Longevity

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