Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic <span class="attribute-to-highlight medbox">and</span> health surveys show a rise in the contribution of neonatal deaths to infant <span class="attribute-to-highlight medbox">and</span> child mortality. The Government of Nepal has implemented community-based programs that were piloted <span class="attribute-to-highlight medbox">and</span> then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, <span class="attribute-to-highlight medbox">and</span> integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, <span class="attribute-to-highlight medbox">and</span> insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional <span class="attribute-to-highlight medbox">and</span> service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.