Leela Khanal | October 2015
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Presentation at the Global Maternal Newborn Health Conference, October 19, 2015

Background: Nepal’s Chlorhexidine program was launched by the Ministry of Health and Population (MOHP) in 2011 and has been implemented in 49/75 districts of Nepal, reaching approximately 66% of the population. A plan for nationwide coverage by 2017 has been developed.

Methods: Since the inception of the CHX program, the MOHP has led the activities and involved the private sector, professional societies, external development partners and other implementing partners through the Chlorhexidine Technical Working Group. Integration of Chlorhexidine into existing MOHP maternal, newborn and child health programs helps to ensure coverage at scale, high compliance and sustainability of the program. Availability of a quality CHX product locally was ensured from the planning phase of the program. Chlorhexidine digluconate 7.1 % w/v (delivering CHX 4%) for cord care is included on the National Essential Drug List and the multi-year procurement and forecasting plan of the MOHP. Nepal is prioritizing community-based demand creation for CHX and has included CHX in the pre-service training curriculum for Skilled Birth Attendants.

Results: Chlorhexidine is included in both the Health Management Information System and Logistics Management Information System, to record utilization, distribution and stock status. Chlorhexidine use and availability is included in the routine monitoring system of all implementing partners and is monitored at national and subnational level through various surveys. JSI/CNCP uses both HMIS data and project monitoring information to improve program performance at national, district, health facility and community level. This paper will present the current available data for coverage of Chlorhexidine use among all live births in program districts.

Conclusion: Chlorhexidine can be a game changer to save newborn lives and high coverage at scale is possible through integration with existing government programs and systems.