Sub-Optimal Quality of Care for Possible Severe Bacterial Infection in Private Sector Outlets of Nepal

Neonatal mortality in Nepal is 21 per 1,000 live births. Newborn deaths contribute to over 50% of under-five deaths (Nepal Demographic Health Survey, 2016). Possible severe bacterial infection (PSBI) is a major cause of death for newborns. Nepal has rolled out a Community-Based Integrated Management of Newborn and Childhood Illness (CB-IMNCI) program across the country that includes treatment of PSBI at the community-level when a referral is not possible. However, this program excludes the private sector. Most cases of sick children under five years of age seek care from private medicine shops/clinics; little is known about the appropriateness and quality of care provided.

Save the Children conducted a nationally representative survey in 2017 to characterize the quality of PSBI care services in the private sector. Survey objectives included:

• To document the appropriateness of care that private medicine shops and clinics in Nepal provide for PSBI in sick infants ages 0–2 months

Specific objectives:

1. Characterize current practices of service providers in private medicine shops and clinics in assessment, treatment, referral, and follow-up of sick young infants
2. Compare these practices with nationally and globally recommended practices
3. Identify factors that influence providers’ practices that could be amenable to improvement efforts