James Wylie Thomas1, David Phillip Levy2, Ang Jangmu Sherpa3, Lakpa Lama4, Allison Judkins5, Amber A Chambers6, Hillary Crandall7, Sarah Schoenhals8, Kirk B Bjella9, Jordan H Vaughan10, Peter H Grubb5, Bernhard Fassl11. 1. Pediatrics - Neonatology, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA. james.thomas@hsc.utah.edu. 2. Oneworld Community Health Center Inc - Pediatrics, 4920 S 30th St, STE 103, Omaha, NE, 68107, USA. 3. Human Right, Peace and Development Forum Nepal, Khumbupasanglhamu 2, Solukhumbu, Nepal. 4. Human Right, Peace and Development Forum Nepal, Solududhkunda 4, Solukhumbu, Nepal. 5. Pediatrics - Neonatology, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA. 6. Pediatrics - Inpatient Medicine, University of Utah, 100 N Mario Capecchi Drive, Salt Lake City, UT, 84113, USA. 7. Pediatrics - Critical Care Medicine, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA. 8. Surgery - General, University of Utah, 30 N 1900 E, Salt Lake City, UT, 84132, USA. 9. CHC - Pediatrics, Northern Valley Indian Health, 1515 Springfield Dr, STE 175, Chico, CA, 95926, USA. 10. Pediatrics, University of Utah, 81 N Mario Capecchi Drive, Salt Lake City, UT, 84113, USA. 11. Center for Global Health Innovation, Northeast Ohio Medical University, 4209 St, OH-44, Rootstown, OH, 44272, USA.
Abstract
INTRODUCTION: Despite significant improvements in recent years, maternal and neonatal health outcomes remain poor in many regions of the world. One such area is in the remote mountainous regions of Nepal. The purpose of this study is to describe the current antenatal care practices and delivery support in a mountainous district of Nepal. METHODS: This study took place in Solukhumbu District between December 2015 and February 2018. A household survey was created using evidence-based maternal and neonatal care indicators. Women who had delivered within the previous two years were surveyed regarding antenatal and delivery care they received. A standardized health facility survey was used to evaluate the operational status of health facilities. The study was approved by the Nepal Ministry of Health and the University of Utah IRB. RESULTS: A total of 487 households and 19 facilities were surveyed. 35.7% (174/487) of deliveries occurred in a health facility (hospital, primary health care center or birthing center). 35.2% (171/486) of deliveries were attended by a skilled birth attendant. 52.8% (47/89) of women who did not deliver in a facility noted that transportation issues and not having sufficient time to travel during labor prevented them from delivering in a facility. No health posts had staff trained in obstetric and neonatal emergencies. DISCUSSION: The majority of women in Solukhumbu District do not receive high quality antenatal and delivery care. An intervention that would make antenatal care and delivery support more accessible could improve maternal and infant outcomes in this district and other similar regions.
INTRODUCTION: Despite significant improvements in recent years, maternal and neonatal health outcomes remain poor in many regions of the world. One such area is in the remote mountainous regions of Nepal. The purpose of this study is to describe the current antenatal care practices and delivery support in a mountainous district of Nepal. METHODS: This study took place in Solukhumbu District between December 2015 and February 2018. A household survey was created using evidence-based maternal and neonatal care indicators. Women who had delivered within the previous two years were surveyed regarding antenatal and delivery care they received. A standardized health facility survey was used to evaluate the operational status of health facilities. The study was approved by the Nepal Ministry of Health and the University of Utah IRB. RESULTS: A total of 487 households and 19 facilities were surveyed. 35.7% (174/487) of deliveries occurred in a health facility (hospital, primary health care center or birthing center). 35.2% (171/486) of deliveries were attended by a skilled birth attendant. 52.8% (47/89) of women who did not deliver in a facility noted that transportation issues and not having sufficient time to travel during labor prevented them from delivering in a facility. No health posts had staff trained in obstetric and neonatal emergencies. DISCUSSION: The majority of women in Solukhumbu District do not receive high quality antenatal and delivery care. An intervention that would make antenatal care and delivery support more accessible could improve maternal and infant outcomes in this district and other similar regions.
Authors: Mark Zimmerman; Sharada Shah; Rabina Shakya; Bal Sundar Chansi; Kashim Shah; Daniel Munday; Nir Eyal; Bruce Hayes Journal: Bull World Health Organ Date: 2015-11-02 Impact factor: 9.408