The United States' decision to significantly cut foreign aid funding has been linked to an increase in pregnancy complications and deaths among mothers and infants in Nepal, according to an investigation by The Associated Press.
The reduction in aid, particularly from the U.S. Agency for International Development (USAID), has led to the closure of maternal and neonatal care programs, the decimation of nutrition initiatives for pregnant women and children, and left birthing centers without essential equipment, medicine, and staff.
Health officials and aid workers in Nepal report a noticeable rise in maternal and neonatal deaths since the funding cuts. Mona Sherpa, country director for CARE Nepal, stated that the number of maternal deaths occurring within a year is now happening within four to six months. The U.S. State Department maintains that its assistance programs have been refocused for efficiency and effectiveness, and that the U.S. remains the largest donor of health and humanitarian aid globally. They also asserted that other nations need to increase their contributions.
However, the AP has documented cases in Nepal where women and children have died due to the diminished support. A study published in The Lancet suggests that U.S. funding cuts could result in over 14 million deaths by 2030, including more than 4.5 million children under the age of five.
Impact on Local Communities
In Nepal's Rautahat district, a region with high poverty and low literacy rates, health workers have observed a significant decrease in women attending prenatal check-ups since the cessation of U.S.-funded programs. Kishori Shah, officer in charge at a birthing center in Dewahi Gonahi municipality, noted that this decline in prenatal care means complications are not being identified quickly enough, leading to emergencies.
Previously, a five-year, $35 million U.S.-funded program in Nepal had reached over 100,000 women and girls. This program provided training for nurses, midwives, and community health volunteers, who conducted regular home visits to educate pregnant women about warning signs and encourage them to seek medical attention. With the program's cancellation, many women are left without guidance in navigating a healthcare system they often struggle to trust or understand.
Personal Stories of Loss
The consequences of these cuts are starkly illustrated by the experiences of individuals like Kabita Mukhiya. Kabita, a young mother from a rural village, suffered complications during her fourth pregnancy. Despite experiencing severe symptoms for weeks, she was unaware of the seriousness of her condition due to the absence of regular outreach from aid workers who had previously provided nutritional supplements and health advice. When she finally sought medical help, her baby was stillborn, and she later died from complications including severe anemia and preeclampsia, conditions that could have been managed with adequate prenatal care.
Another woman, Phula Devi, who is not yet 20 and illiterate, experienced the death of her newborn due to a stillbirth. She did not understand the medical advice given to her, including the recommendation for a C-section, and ultimately delivered the baby unassisted. The lack of accessible information and support, previously provided by U.S.-funded programs, left her unable to comprehend the risks and necessary interventions.
Data Collection and Challenges
Many deaths attributed to the funding cuts are likely to remain undocumented. The cuts have led to job losses for mortality data collectors, leaving gaps in reporting. In Dewahi Gonahi, for instance, mortality reporting services have collapsed, meaning the official government records may not reflect the true number of infant deaths in the municipality.
Experts like Rajat Khosla, executive director of WHO’s Partnership for Maternal, Newborn and Child Health, express deep concern over the reversal of decades of progress in global health. The Gates Foundation has predicted that 2025 could be the first year this century to see an increase in child deaths globally, a trend that health officials are bracing for.