Abstract
Background. Nepal is set to achieve MDG-5 goals by end of 2015. However, maternal health parameters will remain way below those of developed countries. This study was conducted to assess the factors contributing to utilization of ANC and safe delivery services with the aim of furthering overall maternal health parameters in Nepal.Material and Methods. Using survey data from the Nepal Demographic and Health Survey 2011, socio-economic and demographic factors associated with the utilization of ANC and safe delivery services among women aged 15–49 years who gave births during the last three years preceding the survey are examined. Data was segregated into three ecological zones: Mountain, Hill and Terai zones for univariate analyses. Data from all three zones was then pooled for univariate and multivariate logistic regression analyses of Antenatal Care and Safe Delivery services in Nepal.Results and Conclusion. The analyses show that rural place of residence is at a disadvantage in receiving ANC (OR, 0.8; 95% CI [0.7–0.9]) and ensuring safe delivery (OR, 0.6; 95% CI [0.5–0.7]). Woman’s education, husband’s education and wealth quintile are significant factors in ensuring ANC and safe delivery services. Further, the analyses show that Budh/Muslim/Kirat/Christians are at a significant disadvantage in ensuring safe delivery (OR, 0.8; 95% CI [0.7–0.9]) as compared with Hindus. Though ecological zones lost their significance in receiving ANC, women in the Terai region are at a significant advantage in ensuring safe delivery (OR, 1.7; 95% CI [1.2–2.1]).Recommendation. Segregated targets should be set for the different ecological zones for further improvement in maternal mortality rates in Nepal.
Highlights
Almost 300,000 women die every year from causes related to pregnancy and childbirth around the world
Though it seems likely that Nepal will achieve the projected target of 60% of childbirths having a skilled birth attendant (SBA), Nepal Demographic and Health Survey 2011 (NDHS 2011) data suggests that that alone may not be enough to bring down maternal mortality ratio
Since socio-economic and demographic factors are the core of population-based surveys, this paper examines the influence of socio-economic and demographic factors in the use of maternity care services across the three ecological zones in Nepal based upon data collected from the NDHS 2011
Summary
Almost 300,000 women die every year from causes related to pregnancy and childbirth around the world. At the level of policy implementation, this translates into offering effective antenatal care (ANC) services and ensuring a skilled birth attendant (SBA) during childbirth for safe delivery. The MDG-5 has set the goal of increasing the proportion of births attended by a SBA to 60% in 2015 They have set the target of ensuring at least four antenatal care visits during pregnancy to 80% in 2015. Using survey data from the Nepal Demographic and Health Survey 2011, socio-economic and demographic factors associated with the utilization of ANC and safe delivery services among women aged 15–49 years who gave births during the last three years preceding the survey are examined. Data from all three zones was pooled for univariate and multivariate logistic regression analyses of Antenatal Care and Safe Delivery services in Nepal.
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