Safe delivery care: policy, practice and gaps in Nepal

Area of Science:

• Public Health
• Maternal Health
• Healthcare Access

Background:

• Childbirth practices vary globally, influenced by healthcare accessibility.
• Nepal's National Health Policy (1991) prioritized safe motherhood, leading to a significant reduction in maternal mortality ratio.
• Despite progress, skilled birth attendance and institutional delivery rates lag behind Millennium Development Goal 5 targets.

Purpose of the Study:

• To evaluate the impact of Nepal's safe motherhood initiatives.
• To identify disparities in skilled birth care utilization.
• To assess the effectiveness of the safe delivery incentive program.

Main Methods:

• Analysis of maternal mortality data from 1990-2011.
• Review of national health policies and safe motherhood programs.
• Examination of factors influencing skilled birth care access.

Main Results:

• Maternal mortality ratio decreased fourfold (1990-2011), nearing Millennium Development Goal 5 achievement.
• Safe delivery incentive programs showed success in increasing skilled birth attendance and institutional deliveries.
• Significant disparities in skilled birth care utilization persist based on residence, wealth, education, and ethnicity.

Conclusions:

• While Nepal has made strides in reducing maternal mortality, current policies are insufficient to ensure equitable access to safe delivery care.
• Addressing socioeconomic and geographic disparities is crucial for improving skilled birth attendance and institutional delivery rates.
• Further targeted interventions are needed to achieve universal access to safe childbirth services.