1 week Ago By Shoyana K.C.
What if your child died from pneumonia because the nearest hospital didn't have a paediatrician or even a bed? For many families in Nepal, this is not a tragic one-off-it's a daily reality. Nepal has made commendable strides in reducing child deaths. In 1996, 118 of every 1,000 children didn't live to see their fifth birthday.
By 2022, that number had dropped to 33. That's significant progress. But let's not mistake improvement for resolution.
We are still far from the global goal of reducing under-five deaths to 25 per 1,000 live births by 2030. And behind the national averages lie deep and dangerous cracks: newborns dying within days of birth, children with treatable illnesses not reaching a doctor in time, and families in remote districts left to rely on traditional remedies when basic medical care is out of reach. Over half of all child deaths in Nepal happen in the first month of life.
That's 27 out of every 1,000 newborns who don't survive their first four weeks. These early deaths-due to infections, complications at birth or lack of skilled care-are largely preventable. Yet too many hospitals lack the equipment, space or trained staff to manage newborn emergencies.
Nepal's immunisation campaigns have saved countless lives. Polio was eliminated in 2010. Maternal and newborn tetanus, gone since 2005.
These are remarkable achievements. But none of that matters to a mother whose newborn can't access oxygen because there's no neonatal intensive care unit within reach. Nepal's majestic mountains might dazzle tourists, but for a mother in labour in a remote village or a father carrying a feverish child across hills, they represent danger and delay.
Many families can take days to reach a hospital-if one is reachable at all. Consider this: Nepal has fewer than 1,000 pediatric beds for over 12 million children. Most hospitals are designed for adults, leaving children without suitable care.
In rural areas, only 62 per cent of women receive four antenatal checkups. In cities, it's 76 per cent. Among the poorest families, only a third deliver in health facilities-compared to 90 per cent of the richest.
These aren't just statistics. They are mothers giving birth on kitchen floors and babies dying for lack of sterile instruments or skilled hands. Easily treatable illnesses like diarrhoea and pneumonia are still among the top killers of young children in Nepal.
The danger isn't just the disease-it's the delay in treatment. Families wait too long to seek help, either because the clinic is too far or because they simply can't afford it. By the time they arrive, it's often too late.
While traditional remedies have cultural value, they can't replace antibiotics or incubators. Sick children need real medical interventions, not just hope and herbs. Around 2 per cent of Nepali children live with physical disabilities, yet very few receive the rehabilitation or mental health support they need.
The health system was simply not built with them in mind. As a result, these children remain on the fringes-physically and metaphorically. But there is hope-and a model worth backing.
The Kathmandu Institute of Child Health (KIOCH), a non-profit founded in 2017, is building Nepal's first dedicated children's hospital with 200 beds. This isn't just about new buildings but a new way of delivering care. KIOCH is developing a "hub-and-spoke" system: a central facility in Kathmandu linked to smaller provincial centres.
Its first satellite hospital in Damak has already treated more than 140,000 children. That tells us something simple but powerful: the demand is there, and the model works. Technology can help bridge the gap where geography gets in the way.
Health workers in rural areas can connect with specialists in Kathmandu with a basic internet connection or a smartphone. Telemedicine won't replace every hospital visit but can guide diagnoses, inform treatments and prevent dangerous delays. If scaled correctly, it could revolutionise how Nepal delivers child healthcare.
To close the child health gap, Nepal must invest in a system that works for all children, not just the urban and the wealthy. This starts with building more child-friendly hospitals, especially in underserved regions. Not every district needs a full-fledged facility, but every province must have a centre capable of handling pediatric emergencies.
We must also train and retain pediatric specialists-not just doctors, but nurses, therapists and mental health workers. Scholarships and rural service incentives can help keep talent where it is needed most. Financial barriers must be tackled, too.
Health insurance should cover all pediatric emergencies so that no parent must choose between feeding their family or saving their child's life. For families in remote areas, transportation costs must be subsidised. If we can't bring the hospital closer to the child, let's help the child get there.
And let's not forget the most overlooked: children with disabilities. Facilities must include physiotherapy and mental health services, and health workers must be trained to meet the needs of children living with disabilities. Inclusion should be built into every level of planning.
Investing in child health isn't just the right thing to do-it's also smart. Healthy children learn better, earn more and contribute to society in ways that pay dividends for generations. With nearly 40 per cent of Nepal's population under 18, this is not a side issue.
It is our nation's future. Every day we delay, another 33 children die-needlessly. Nepal has shown it can win big health battles before.
It's time to bring that same resolve to the fight for every child's right to survive and thrive. Let's not allow geography or poverty to determine who gets to grow up..
