Nepal

Better maternal health care saves the lives of women and children in Nepal

© UNICEF Nepal/2006/Karki

Anupa Rai with her newborn son in Nepal, two days after an emergency caesarean section saved her life and the life of her child.

By Jane O’Brien

NEW YORK, USA, 27 September 2006 – More than 1 in every 200 pregnant women in Nepal dies giving birth. A lack of access to medical care, poor health education and the low status of women are the main causes. But by working with local communities, UNICEF and its partners are helping to reduce maternal deaths across the region.

The Panchthar District of eastern Nepal is mountainous with few roads. Women and babies often die as mothers try to reach the nearest health facility, which can be up to a day’s walk away. Through a series of intensive workshops and consultations, UNICEF has helped local services identify the needs of such isolated communities and act accordingly.

“Until two years ago, there was no concept of safe motherhood or birthing centres in Panchthar,” says District Health Officer Dr. Guna Raj Lohani. “Now we have skilled birth attendants, a dozen birth centres and antenatal clinics in all wards.”

Emergency services

UNICEF has also worked with communities to raise awareness of basic maternal and infant care, and the need to act quickly in an emergency. This approach, combined with better facilities, almost certainly saved the life of Anupa Rai.

© UNICEF Nepal/2006/Karki

Surgeons deliver Anupa Rai’s son by caesarean section.

Ms. Rai’s community made sure she received regular antenatal check-ups, which detected complications in her pregnancy. When she needed help the hospital was prepared and subsequently able to perform emergency surgery. She now has a healthy son.

“We focussed our energy to address these issues,” says UNICEF Project Officer Dr. Geetha Rana. “We started from the communities and worked upwards using existing health delivery systems.”

Obstetric care fund

Poverty is often a major impediment to women seeking health care in Nepal. To overcome this obstacle, an emergency obstetric care fund has been established, funded by local governments and community contributions that are matched by UNICEF.

In one village, the fund helped to pay for a screening programme for prolapsed uterus – a condition that affects almost a third of women of reproductive age.

“The culture of silence that pervades this problem is the same with other reproductive health complications,” says Dr. Lohani. “The solution lies in the community, both men and women, opening up and discussing the problems.”

In the six districts where UNICEF is promoting safe motherhood in Nepal, there has been a significant increase in the number of pregnant women using emergency obstetric care. With improved education, more mothers are aware of the lifesaving services that are available to them.