Chlorhexidine in Nepal: A Public‐Private Partnership Case Study

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In Nepal, newborn mortality has remained unchanged at 33 per 1,000 live births over the five years preceding the 2011 DHS study, compared with the preceding five years. Cleansing newborn umbilical cord stumps with 7.1% Chlorhexidine Digluconate solution has been demonstrated to reduce newborn mortality by 23 percent. Chlorhexidine in a gel formulation has been found more acceptable to users; this product was developed and piloted in Nepal. After the success of the pilot, the Nepal Government endorsed use of chlorhexidine for cord care as a part of essential newborn care in December 2011.

By the start of 2013, Nepal is moving forward as the first country in the world to adopt chlorhexidine for newborn cord care and the intervention has reached 36 of 75 districts in Nepal is also exporting chlorhexidine gel to other countries for both piloting and program purposes.

Lomus Pharmaceuticals developed the product for Nepal—and now also supplies other markets. Lomus takes pride in being the first pharmaceutical company in the world manufacturing chlorhexidine gel for newborn cord care.

This experience of public‐private partnership has taught us that members of the private sector are willing and can be flexible enough to invest in public health programs that do not have immediate commercial promise, if they are well informed of its impact, are fully involved as a partner, and are trusted by both the public sector and technical assistance partners.

The trusting relationship that developed was found to be an important factor contributing to the evolution of this successful public‐private partnership.

This case study maps out the development of that partnership, examines the issues confronted, and the lessons learned.