| Biswo |
Posted
on 20-Nov-00 01:46 AM
Armed with strategy and funds, Nepal looks to save
pregnant lives
By Meena Kaini
TUNIS, Tunisia, Nov 17 - It's difficult to believe, especially if you live in the
bustling metropolis of Kathmandu. But in the whole of Nepal, of which Kathmandu is a
very small part, there exists only 12 trained midwives.
No wonder, say experts, that a dozen women die each day from pregnancy related
complications in Nepal, a country where 90 per cent of the delivery is carried out
at home without any qualified attendants. And what has resulted in such poor
statistics?
As health experts point out, the major hindrance is created by misallocation of
scarce funds, as well as lack of human resources, and the low level of acceptance of
the health service providers by the community. Culture plays a key role and the
traditional health practices get by without anybody questioning them. Nepal's
difficult topography, creating poor accessibility to the health centre, only adds to
the problem.
In order to bring down the number of deaths due to complications related to
pregnancy and childbirth, Nepal is developing and embracing the National Safe
Motherhood Plan of Action starting December.
The conference "Saving Lives: Skilled Attendance during Childbirth" ended with a
pledge from the government officials as well as the non-government partners for
concerted efforts to reduce the maternal mortality with special emphasis to make the
policymakers aware of the gravity of the problems faced by women in the country. The
plan of action formulated after the extensive discussions between the government
officials, NGO partners and experts specializing on women's health has put special
focus in using the media to dispense information as well as to create awareness.
"We need to formulate a comprehensive strategy to develop necessary human resources
so that every pregnant woman could be attended to and reduce the risk of
complications," said Dr B D Chataut, Director General at the Department of Health
Services (DoHS) at Ministry of Health, who is also attending the conference here.
Nepal's situation in availability of the services to women is like this: there is no
assistance available for 11 per cent of the deliveries, while friends and relatives
provide assistance in 56 per cent of the cases. According to statistics provided by
DoHS, doctors and nurses provide delivery care in nine per cent of the cases and
Maternal and Child Health Workers (MCHW) and other professionals assist in only over
one per cent of the cases. One Village Development Committee (VDC) has only one MCHW
responsible for the total women and child population of the VDC.
Compare this to Sri Lanka, where the coverage by skilled attendant during childbirth
exceeds 96 per cent.
"The community never seeks the service providers during pregnancy and delivery,
which clearly shows that delivery is never taken seriously," said Dr Kritanjali
Koirala of Focal Point for Safe Motherhood at Family Health Division, Ministry of
Health.
Experts say that any woman can experience life-threatening and unpredictable
complications that require immediate medical care during pregnancy. Out of the total
2,786 physicians registered with Nepal Medical Council, only 130 are
obstetricians/gynaecologists and almost all, if not all, of them are concentrated in
Kathmandu Valley and other urban centres.
Women in Nepal also face another problem: they have very little say in pregnancy
related decision-making. Rather than they, it is family members, such as husbands
and in-laws, who make decisions for them.
The National Plan of Action has decided to lead awareness programmes on gender
discrimination and its impact on maternal health and use of services. "We need to
reach out to the decision-makers at household level and make them aware of the
complications and consequences," said Dr Ava Darshan Shrestha of Safe Motherhood
Network, Nepal.
With the problems now identified, the policies already in place and those to be
devised in the future await only an effective implementation.
(From Kathmandu Post, By Mina Kaini, Sunday Nov19)
|
