Nepal's maternal health gains unravel as aid cuts take hold

In the dusty villages of Nepal's Rautahat district, the quiet collapse of a maternal health program is exacting a grim toll. Kabita Mukhiya, a young mother from a mud home in rural Nepal, spent weeks in agony during her pregnancy, unaware of the danger. With no aid workers visiting to explain warning signs, she delayed seeking care until it was too late. At the hospital, doctors delivered the news she could not bear: her baby had died, and her own life was in peril.

This tragedy is not isolated. The cancellation of a five-year, $35 million US-funded program, which had reached over 100,000 women and girls, has left a void in communities that depend on outreach. The program had equipped birthing centers, trained nurses, and deployed female community health volunteers who regularly visited pregnant women, urging them to attend prenatal checkups and often escorting them to clinics.

In the municipality of Dewahi Gonahi, the number of women coming for prenatal checks has halved since the funding ended, according to the officer in charge, Kishori Shah. He notes that complications are now being identified too late, leading to more emergencies. In the nearby village of Prempur Gonahi, the officer in charge, Sadho Baitha, reports that after the program's launch in December 2022, neonatal deaths dropped to zero by 2024. But within ten months of the program's cancellation, newborns began dying again—five by March.

Health workers and officials say the true scale of the loss is likely undercounted. The funding cuts also eliminated many data collection jobs, leaving no one to record deaths. Shatrudhan Singh, executive director of Campaign Nepal, a partner organization, says the official record shows just two infant deaths in Dewahi Gonahi since the cuts, though his group knows of eight. "There must be more than that," he says. "We just can't identify them."

The human cost is visible in the homes of the bereaved. Phula Devi, a woman under 20 who never attended school, lost her baby in January. An informal health practitioner had warned her of a slow fetal heartbeat and told her to go to a hospital, but she did not understand. Relatives waited until night to take her in. Terrified by the suggestion of a C-section, she delivered on her own. The baby was stillborn, whisked away before she could see his face.

The US State Department maintains that no deaths have resulted from the funding cuts and says it still supports maternal and child health programs in Nepal. However, the World Health Organization reports that 60% of women's organizations globally have reduced services due to the cuts. A study in The Lancet projects that the cuts could lead to more than 14 million deaths by 2030, including over 4.5 million children under five. For now, in Nepal's poorest districts, the progress of recent years is quietly reversing, one preventable death at a time.