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Maternal Mortality in Nepal: Identifying High-Risk Groups Through Census Data.

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Maternal deaths in Nepal are preventable and linked to social and geographic inequalities. Most deaths occur postpartum, disproportionately affecting poorer women in rural areas, highlighting the need for targeted interventions.

Keywords:
Low- and middle-income countriesMaternal deathMaternal mortalityNepal

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Area of Science:

  • Public Health
  • Demography
  • Sociology

Background:

  • Nepal faces a high maternal mortality ratio despite preventability, marked by significant social and geographic disparities.
  • Limited disaggregated national data hinder understanding of how factors like education, income, and residence impact maternal mortality risk.
  • Existing research indicates a need to explore social determinants and the timing of maternal deaths for effective intervention.

Purpose of the Study:

  • To examine the social determinants and timing of maternal deaths in Nepal.
  • To identify high-risk groups for maternal mortality to inform targeted interventions.
  • To analyze national data for a representative understanding of maternal mortality patterns.

Main Methods:

  • A cross-sectional descriptive study utilized microdata from the 2021 National Population and Housing Census of Nepal.
  • A stratified, probability-based sampling design ensured national representativeness, identifying deaths among women aged 15-49 through household reports.
  • Data collected included sociodemographic characteristics, household wealth, ethnicity, place of residence, and cause/timing of death (pregnancy, childbirth, postpartum).

Main Results:

  • Out of 1,386 deaths among women aged 15-49, 54 (3.9%) were maternal deaths, with 74.6% occurring postpartum.
  • Maternal deaths were concentrated in Lumbini province, peri-urban/rural areas, and the Tarai region, with nearly half occurring in poor households.
  • Non-communicable diseases were the leading cause of death overall (49.9%); most maternal deaths involved women aged 20-34.

Conclusions:

  • Maternal mortality in Nepal is significantly influenced by social and geographic inequalities, with increased risk for poorer women, rural/peri-urban residents, and specific provinces.
  • The postpartum period is a critical high-risk phase for maternal mortality.
  • Strengthening antenatal care, skilled birth attendance, and implementing equitable, context-specific interventions are crucial for reducing preventable maternal deaths.