Safe Motherhood Indicators in Nepal
- More than 8 in 10 women (84%) age 15-49 receive antenatal care (ANC) from a skilled provider (doctor, nurse, and auxiliary nurse midwife).
- Two-thirds of women have their first ANC visit in the first trimester, as recommended. Seven in ten women make four or more ANC visits.
- The majority of women (91%) take iron tablets or syrup during pregnancy. Eighty-nine percent of women’s most recent births were protected against neonatal tetanus. Among women who received ANC for their most recent birth, 91% had their blood pressure measured, 76% had a urine sample taken, and 66% had a blood sample taken.
Delivery and Postnatal Care
- More than half of births (57%) are delivered in a health facility, primarily in government sector
facilities. However, 41% of births are delivered at home. Women with SLC and above education (85%) and those in the wealthiest households (90%) are more likely to deliver at a health facility. Only 8% of births in 1996 were delivered in a health facility, compared to 57% in 2016.
- Overall, 58% of births are assisted by a skilled provider, the majority by doctors. One in ten births are assisted by no one.
- Skilled assistance during delivery has increased from 9% in 1996 to 58% in 2016. More than half of women (57%) receive a postnatal check within two days of delivery, while 42% did not have a postnatal check within 41 days of delivery.
- 57% of newborns receive a postnatal check within two days of birth, while 40% did not have a postnatal check.
- Among births in the two years before the survey, Chlorhexidine was applied on 39% of newborns, whereas nothing was applied on 37% of newborns.
- The 2016 NDHS asked women about deaths of their sisters to determine maternal mortality. Maternal mortality includes deaths of women during pregnancy, delivery, and 42 days after delivery
excluding deaths that were due to accidents or violence. The maternal mortality ratio (MMR) for
Nepal is 239 deaths per 100,000 live births for the seven-year period before the survey. The confidence interval for the 2016 MMR ranges from 134 to 345 deaths per 100,000 live births.
Ministry of Health, Nepal; New ERA; and ICF. 2017. Nepal Demographic and Health Survey 2016. Kathmandu, Nepal: Ministry of Health, Nepal.
The 2015 Nepal Health Facility Survey (2015 NHFS)
ANTENATAL CARE SERVICES
- About 98 percent of health facilities in Nepal offer antenatal care (ANC) services.
- One in four health facilities offering ANC had at least one staff member who had received inservice training in ANC within the 24 months before the assessment.
- Twenty-five percent of facilities had ANC guidelines available on the day of the assessment.
- More than half of facilities had soap and running water or alcohol-based hand disinfectant for infection prevention available at the service site on the day of the assessment.
- Ninety percent of health facilities had all essential ANC medicines (combined iron and folic acid tablets, and albendazole tablets) available for ANC clients.
- Almost half of all observed ANC clients were counseled on nutrition during pregnancy. One third of clients were advised on issues relating to the progress of their pregnancy. Two out of ten clients were counseled on importance of at least four ANC visits and on birth/planning/preparedness measures.
- Seven in 10 ANC providers had received personal supervision in the six months preceding the survey.
- Two of every 10 facilities offering ANC provide at least some services for prevention of mother-to-child transmission (PMTCT) of HIV.
- Only 6 percent of facilities offering ANC had insecticide-treated nets available to give to ANC clients for malaria prevention.
DoHS, Annual Report 2072/73 (2015/16)
- % of pregnant women who received Td 2 and 2+= 66
- % of pregnant women attending first ANC visit = 97
- % of pregnant women attending four ANC visits =51
- % of pregnant women receiving IFA tablets or syrup during their last pregnancy= 49
- % of postpartum mothers who received vitamin A supplements = 51
- % of institutional deliveries =55
- % of deliveries conducted by a skilled birth attendant =54
- % of postpartum women received PNC checkup within 24 hours of birth =52
- % of women who had three PNC check-ups as per protocol = 18