The Trump administration eliminated the United States Agency for International Development last year, a move that triggered the closure of maternal health programs in Nepal. The death of Kabita Mukhiya from complications of eclampsia illustrates the human cost of these policy changes.

Mukhiya was a 20-year-old uneducated woman living in a poor village near the India border. She experienced excruciating stomach pains, severe swelling and delirium during her pregnancy. Mukhiya suffered at home for weeks before her aunt took her to the hospital. She died from complications of eclampsia, with severe anemia contributing, and her unborn baby also died.

Rajkumari Patel worked as an outreach worker under CARE’s canceled program. She identified specific warning signs that went unchecked in Mukhiya's case. "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. I would have looked at her eyes for signs of anemia," 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 funding cuts eliminated nutrition programs that provided supplements and food items to impoverished pregnant women in Nepal. They also closed a program that equipped birthing centers and trained nurses, midwives and outreach workers in Nepal. Outreach workers regularly visited pregnant women’s homes, explained warning signs of complications, and urged them to attend prenatal appointments, often escorting them.

The canceled program reached 100,000 women and girls across Nepal in its first three years. The program was a five-year, $35 million initiative.

Mona Sherpa is the country director for the aid group CARE Nepal. Her organization lost more than half its funding from the U.S. cuts. "The number of deaths of mothers, young mothers, during delivery has really increased," Sherpa said. "The expected number within a year is happening within four to six months."

The impact is visible in the village of Prempur Gonahi, where Sadho Baitha serves as the officer in charge. Before CARE’s program launched in Rautahat in December 2022, the village averaged 10 to 15 neonatal deaths per year. By 2024, records show there were zero neonatal deaths in Prempur Gonahi. Since the program’s cancelation, newborns have begun dying again in Prempur Gonahi; the first was in December, and four more followed by March.

Kishori Shah is the officer in charge at a birthing center in Rautahat’s municipality of Dewahi Gonahi. The number of women coming for prenatal checks at the birthing center in Dewahi Gonahi has halved since the funding cuts, according to Shah. The cuts left scores of mortality data collectors jobless in some places.

Why It Matters

The World Health Organization stated that U.S. cuts, followed by foreign aid cuts from several other countries, forced 60% of women’s organizations to reduce their services. Rajat Khosla is the executive director of WHO’s Partnership for Maternal, Newborn and Child Health. "It’s heartbreaking to see what’s happening. It’s decades of progress being washed away," Khosla said.

The Gates Foundation predicted that 2025 will be the first year this century where child deaths will increase due to cuts by the U.S. and other countries to foreign aid. A study published in The Lancet journal said the U.S. cuts could lead to more than 14 million deaths, including more than 4.5 million children under age 5, by 2030.

Timeline

Before CARE’s program launched in Rautahat in December 2022, the village of Prempur Gonahi averaged 10 to 15 neonatal deaths per year. By 2024, records show there were zero neonatal deaths in Prempur Gonahi. The Trump administration eliminated the United States Agency for International Development last year.

What's New

The U.S. State Department stated, "The rest of the world needs to contribute more and share the burden." Rajat Khosla is the executive director of WHO’s Partnership for Maternal, Newborn and Child Health. The U.S. State Department stated the Trump administration had reinvigorated its assistance programs to focus on efficiency, effectiveness and partnership. "It’s heartbreaking to see what’s happening. It’s decades of progress being washed away," says Rajat Khosla. The U.S. State she stated the U.S. spends more on health and humanitarian assistance than any other country. Kishori Shah is the officer in charge at a birthing center in Rautahat’s municipality of Dewahi Gonahi. A study published in The Lancet journal said the U.S. cuts could lead to more than 14 million deaths, including more than 4.5 million children under age 5, by 2030. The program was a five-year, $35 million initiative.