Review of socio-economic factors in reducing maternal mortality in Nepal
Authors: Panday, S., Simkhada, P. and van Teijlingen, E.
Conference: Midwifery and the post MDG agenda Conference
Dates: 5 February 2014Abstract:
Nepal is one of the few countries which appear to have reduced itsmaternal mortality by three-fourth between 1990 and 2010 - overall 78% reduction. This narrative review identifies socioeconomic factors associated with maternal mortality in Nepal. A systematic search of English electronic journals was conducted by using databases Medline, Embase, Scopus, Web of Science, Popline, ASSIA, and Google Scholar including “grey literature” especially policy documents published by private and governmental organisations dated from 1995 to September 2013. Both qualitative and quantitative studies were selected where maternal mortality was measured as an outcome. Some 38 articles including 6 government documents were included in the review and most of them were grey literature and survey studies discussing maternal mortality in Nepal. Key factors highlighted comprise (a) poverty reduction as Nepal reduced its poverty from 42% to 25% and (b) education has increased by 48% in the last 15 years. These changes combined with reduced fertility, growing contraception use, increased age at marriage and higher women autonomy were significantly associated with maternal mortality reduction. Caste/ethnic group and area of residence were also associated with maternal mortality. Community awareness combined with increased remittances and transportation facilities in remote areas helped to improve access to treatment in cases of complications. Currently, users do not need to pay for the maternity services at public facilities and conditional cash transfer programmes exist including access to safe abortions. Achieving its Millennium Development Goal 5 target Nepal could be a lessons for other similar countries.
Preferred by: Edwin van Teijlingen