Maternal Mortality in Nepal: Latest Findings and Implications for Sustainable Development.

Nepal Witnesses A Significant Drop In Maternal Mortality Rate According to Dual Study Conducted During National Census 2021

The maternal mortality rate in Nepal has significantly decreased, as per the dual study conducted during the National Census 2021. The study is claimed to be the first of its kind in the world, where maternal mortality has been detected through a dual method. The study revealed that the maternal mortality rate in Nepal is 151 per 100,000 live births, which is still considered high. The sustainable development goal requires Nepal to reduce the maternal mortality rate to less than 70 per 100,000 live births.

The previous surveys showed a much higher maternal mortality rate. The 2011 census showed that 400 deaths out of every 100,000 women in Nepal were related to pregnancy. Due to the lack of diversification in its analysis, the Ministry of Health and Population conducted a separate survey based on the mortality rate of 28 women based on sample selection and showed a maternal mortality ratio of 239 in a total of 100,000 women. However, the dual method adopted during the National Census 2021 has removed such confusion.

The study found that 622 out of 653 maternal deaths from November 25, 2020, to November 25, 2021, were pregnancy-related. The causes of maternal mortality include non-obstetrical complications, high blood pressure during delivery, high blood pressure problems, pregnancy-related infections, suicide, abortion, problems in anesthesia management during surgery, and other reasons. The Ministry of Health and Population is soon making a plan to carry out improvement programs according to the state of maternal mortality in every province.

According to Kapil Prasad Timalsena, Deputy Secretary of the Population Management Division, although the reduction in maternal mortality is a good thing, it is still complicated by various factors. The study has given the authorities a clue as to what are the causes of maternal mortality and other factors.

According to geographic location, the maternal mortality rate is 133 per 100,000 in the mountains, 159 in the hills, and 147 in the Terai. According to the regional structure, the maternal mortality rate is 98 per 1 lakh in Bagmati province and 27 per 1 lakh in Lumbini province. The maternal mortality ratio is 172 in Karnali Province, which is considered a remote area, 161 in Gandaki, 130 in Far West, and 140 in Madhesh Province. In Koshi province, which is considered accessible, there is a maternal mortality rate of 157 per 100,000.

The study found that the complex reasons for any woman dying within 42 days from the day of conception to the birth of the child are due to three types of delays. These include the pregnant woman not knowing that she should be taken to the hospital in case of difficulty, the health office being far away, and after reaching the health facility, the mother dies because there is no doctor and equipment to serve her. It has been found that 26 percent of mothers still die at home, and due to distance or non-availability of health facilities, 17 percent of mothers die on the way to the health facility.

It has been found that 57 percent of mothers die after reaching the health institution, and there are factors such as the correct use of equipment and service personnel. Most (61 percent) mothers die during childbirth, while there is a 33% maternal mortality rate during pregnancy and 6% during childbirth. Recently, 15% of maternal deaths have been due to Covid infection.

The National Statistics Office and the Ministry of Health have maintained statistical uniformity of the country on a sensitive issue like maternal mortality. With this study, the Ministry of Health and

continue from the line: The National Statistics Office and the Ministry of Health have maintained statistical uniformity of the country on a sensitive issue like maternal mortality. With this study, the Ministry of Health and

Population is now planning to carry out targeted improvement programs according to the state of maternal mortality in every province of Nepal. The study has identified various causes of maternal mortality, including non-obstetrical complications, high blood pressure during delivery, pregnancy-related infections, suicide, abortion, problems in anesthesia management during surgery, and other factors.

Geographically, the study found that the maternal mortality rate is highest in the mountainous region with 133 deaths per 100,000 live births, followed by the hills with 159 deaths and the Terai with 147 deaths. According to the regional structure, Bagmati province has the lowest maternal mortality rate at 98 per 100,000 live births, while Lumbini province has the highest rate at 270 per 100,000 live births.

The study also revealed that there are three types of delays that lead to the death of pregnant women during their journey to delivery. These delays include the pregnant woman's failure to recognize the need for medical attention, distance or non-availability of health facilities, and the lack of medical personnel and equipment to provide proper care. While 57% of mothers die after reaching a health institution, 17% die on the way to the facility, and 26% still die at home.

Despite the reduction in maternal mortality rates, the study highlights the need for continued efforts to improve maternal healthcare in Nepal. The reduction in maternal mortality is a positive step, but more needs to be done to reduce the rate to less than 70 per 100,000 live births, as per the Sustainable Development Goal. With this study, Nepal can now focus on implementing targeted improvement programs to address the complex causes of maternal mortality and improve the overall maternal health of the country.

Published on 5th April 2023