“The Ministry of Health and Population is taking as much initiatives as possible to ensure that no woman dies due to pregnancy-related complications or while giving birth,” said Dr Sudha Sharma, secretary at the Ministry. “But there are still several challenges that keep the lives of mother and child under threat.”
Speaking at the release of a report entitled “State of the World’s Children 2009”, Sharma said women are most likely to die if they are not taken to health institutions immediately upon bleeding due to pregnancy or delivery-related complications.
The Nepal Maternal Mortality ratio of 281 maternal deaths per 100,000 is equivalent to a woman dying every four hours, and it is widely accepted that many of these deaths are a direct consequence of under-utilization of maternal health services and low quality of care, especially in rural areas, said the report.
Key Figures
Life expectancy at birth – 64
Neonatal mortality rate /1000 live birth – 32
Infant mortality rate /1000 live birth – 43
Under five mortality/ 1000 live birth – 55
“For many Nepalese parents, it takes several days to reach a healthcare center, and the expense of travel can be a deterrent for poor families,” said an excerpt from the report, “For those in need of Emergency Obstetric Care (EOC), this geographical divide is far too often a death sentence for mother and child.” The report with the theme ‘maternal and newborn health’ was released in Nepal Thursday by The United Nations Children´s Fund (UNICEF).
According to the report, newborn mortality in Nepal has reduced to 33 deaths per 1,000 in 2006, compared with 39 per 1,000 in 2001. Two-thirds of total deaths occur in the first week of life, and around 40 percent of neonatal deaths are attributable to preventable causes such as infection.
Dr Sharma said in the situation when a baby is male-positioned in the mother’s womb, or the outlet of the womb is too small to give birth, they would need EOC service. “These are the challenges that the Ministry is still fighting,” she said. “We haven’t been able to send doctors in nine EOC centers in the country.”
The government has started free institutional delivery through 280 government health institutions across the country from this month.
The report acknowledged community health workers for their greater role in minimizing maternal and child mortality. “By providing services during home deliveries, such as proper wiping and wrapping of the baby, encouraging skin-to-skin contact to prevent hypothermia and after-birth asphyxia, and monitoring for severe infections, community workers can prevent 67 percent of all neonatal deaths, experts estimate,” the report said.
Gillian Mellsop, UNICEF representative to Nepal said reasons such as difficult weather conditions and a scarcity of usable roads keeps the maternal mortality ratio high. She also said one in every 21 Nepali children dies before reaching age one, while one in every sixteen does not survive to his or her fifth birthday.
