Under-five mortality reduction in Nepal

Detailed findings

Diarrhea, pneumonia, and malaria

15% of the reduction in under-five mortality between 2000 and 2017

Per IHME estimates

Quantitative modeling results

DECOMPOSITION METHOD

1% of the reduction in under-five mortality between 2000 and 2017 attributed to oral antibiotics, oral rehydration salts (ORS), zinc treatment, and artemisinin-based combination therapies (ACTs).

LIVES SAVED TOOL

35,000 lives saved and 22% of total lives saved from 2000 to 2016 attributed to oral antibiotics, ORS, zinc treatment, and ACTs (the majority attributed to antibiotics for pneumonia).

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Vaccine preventable diseases – measles, lower respiratory infections (LRIs), and meningitis

37% of the reduction in under-five mortality between 2000 and 2017

Per IHME estimates

Quantitative modeling results

DECOMPOSITION METHOD

10% of the reduction in under-five mortality between 2000 and 2017 attributed to Measles, PCV, and Hib vaccination.

3% of the reduction in under-five mortality between 2000 and 2017 attributed to vitamin A and zinc deficiency.

LIVES SAVED TOOL

Measles, PCV, and Hib vaccination: 21,000 lives saved from 2000 to 2016.

Vitamin A supplements: 18,000 lives saved and 12% of total lives saved from 2000 to 2016 attributed to vitamin A supplementation and vitamin A treatment for measles.

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HIV

<1% of the reduction in under-five mortality between 2000 and 2017

Per IHME estimates

Quantitative modeling results

DECOMPOSITION METHOD

<1% of the reduction in under-five mortality between 2000 and 2017 attributed to PMTCT/ART.

LIVES SAVED TOOL

350 lives saved and <1% of total lives saved from 2000 to 2016 attributed to PMTCT/ART.

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Nutritional deficiencies

4% of the reduction in under-five mortality between 2000 and 2017

Per IHME estimates

Quantitative modeling results

DECOMPOSITION METHOD

15% of the reduction in under-five mortality between 2000 and 2017 attributed to changes in child growth failure and suboptimal breastfeeding.

LIVES SAVED TOOL

13,000 lives saved and 8% of total lives saved from 2000 to 2016 attributed to nutrition interventions.

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Neonatal disorders

29% of the reduction in under-five mortality between 2000 and 2017

Per IHME estimates

Quantitative modeling results

DECOMPOSITION METHOD

4% of the reduction in under-five mortality between 2000 and 2017 attributed to reductions in low birth weight.

3% of the reduction in under-five mortality between 2000 and 2017 attributed to skilled birth attendance.

LIVES SAVED TOOL

56,000 lives saved and 35% of total lives saved from 2000 to 2016 attributed to neonatal and antenatal interventions.

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Other factors

Quantitative modeling results

DECOMPOSITION METHOD

6% of overall reduction in under-five mortality between 2000 and 2017 is attributed to improvements in water, sanitation, hygiene, and air quality. Beyond the reductions attributed to interventions and aforementioned risk factors, an additional 27% of the reduction in under-5 mortality is attributed to risk factors from other communicable diseases, other non-communicable diseases, and other injuries.

LIVES SAVED TOOL

14,000 lives saved and 9% of total lives saved from 2000 to 2016 attributed to water, sanitation, and hygiene interventions.

The Lives Saved Model estimates a total of 160,000 lives saved and a reduction in under-5 mortality rate of 33%. The modeled results capture 58% of the observed decline in mortality as estimated by IGME. The additional estimated decline (per IGME estimates) could be attributed to other factors that are not measurable or that fall outside of direct health system interventions (e.g., women’s empowerment and economic development).

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Contextual factors including conomic growth, improvements in gender equality and women's empowerment, education, and improvements in sanitation

The primary research findings suggest additional contextual factors and preconditions for success that contributed to under-5 mortality reductions in Nepal, which were outside of the health system interventions. These include economic growth, improvements in gender equality and women’s empowerment, education, and improvements in sanitation and infrastructure.

Methodology