Public Health Research Seminar: Social Justice through Innovation – Fulfilling an Unmet Need in Nepal

Presented by Janine Yasmin Khan, MD, MBA
Associate Professor of Pediatrics
Feinberg School of Medicine
Northwestern University

Low and middle-income (LMIC) countries, like Nepal, continue to have high neonatal mortality rates (NMR) despite improvement in the recognized top three drivers of NMR (infection, birth asphyxia, and prematurity).

The United Nations has included reduction in NMR as one of its Sustainable Developmental Goals (SDGs); aiming for a reduction of NMR to 12/1000 live births by 2030, but it has remained stagnant at ~21/1000 live births in Nepal since 2016. The cause of many neonatal deaths remains unknown, and reducing the burden of death will be impossible if these causes remain undetermined.

Surveillance systems, like universal newborn metabolic screening (NBS), has played a significant role in public health strategies that impact long-term health outcome in the U.S. and other high-income countries since 1966. NBS identifies neonates with serious, potentially curable disorders, that will benefit from timely interventions, thus preventing neurocognitive impairment, disability, and death.

An innovative approach is needed to address this problem, and the time has come to reduce the disparity of care in LMICs and provide access to tools, like NBS, that have been shown to improve the population health of high-income countries worldwide. This presentation shows the feasibility of fulfilling this unmet need in Nepal, the challenges encountered despite high acceptability of implementing a universal NBS Program, and the ongoing advocacy to make this a reality.