Nepal sees rise in maternal, newborn deaths after USAID shutdown

The dismantling of the United States Agency for International Development (USAID) has had a deadly ripple effect in Nepal, where the closure of maternal health programs is being linked to a rise in deaths of pregnant women and newborns, according to health workers, officials, and families in the country.

The Trump administration's decision to dissolve the agency, once the world's largest humanitarian donor, eliminated nutrition schemes that supplied food and supplements to impoverished expectant mothers. It also ended a program that equipped birthing centers and trained nurses, midwives, and community outreach workers. Those workers had been a lifeline for women in remote villages, visiting homes to explain warning signs of pregnancy complications, urging prenatal visits, and often escorting women to clinics. In its first three years, the initiative reached 100,000 women and girls across Nepal.

Mona Sherpa, country director for the aid group CARE Nepal, which lost more than half its funding due to the cuts, said the impact has been swift and severe. "The number of deaths of mothers, young mothers, during delivery has really increased," she said. "The expected number within a year is happening within four to six months."

In the village of Prempur Gonahi, the officer in charge, Sadho Baitha, said the return of newborn deaths came within 10 months of the program's cancellation. Before CARE's project began in December 2022, the village recorded 10 to 15 neonatal deaths per year. By 2024, that number had dropped to zero. Since the program ended, five newborns have died between December and March.

The human cost is visible in individual tragedies. Kabita Mukhiya, a 20-year-old woman from a poor village near the Indian border, suffered severe stomach pain, swelling, and delirium during her pregnancy. The nutrition supplements she had received in a previous pregnancy were gone, and the outreach workers who once visited her village had stopped coming. She stayed home for weeks, not realizing her symptoms were an emergency. By the time her aunt took her to a hospital, it was too late; Mukhiya and her unborn child died from complications of eclampsia and severe anemia, conditions that regular prenatal care can often catch.

Rajkumari Patel, a former outreach worker under the canceled program, said deaths like Mukhiya's were exactly what her team was trained to prevent. "I would have asked her, 'Is the baby kicking? When did you last feel movement?' I would have checked for swelling in her hands and face," Patel said. "These are the signs I would have noticed in Kabita and said, 'This woman needs a hospital today -- not tomorrow.' Maybe we could have saved her life."

The full scale of the loss may never be known. The funding cuts also eliminated jobs for mortality data collectors, leaving many areas with no one to record deaths. The World Health Organization reports that U.S. cuts, followed by reductions from other donor countries, forced 60 percent of women's organizations worldwide to scale back services. The Gates Foundation has predicted that 2025 will be the first year this century to see an increase in child deaths globally.

The U.S. State Department maintains it still supports maternal and child health programs in Nepal, but those on the ground describe a system in crisis, with many pregnant women now struggling to feed themselves and navigating a medical system they often distrust or do not fully understand.