Policies and actions to reduce maternal mortality in Nepal: perspectives of key informants
Nepal made impressive progress in reducing maternal mortality until 2015. Since then, progress has stagnated, coinciding with Nepal’s transition to a federation with significant devolution in health management. In this context, we conducted key informant interviews (KII) to solicit perspectives on p...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-01-01
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| Series: | Sexual and Reproductive Health Matters |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/26410397.2021.1907026 |
| _version_ | 1818971940844470272 |
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| author | Rajendra Karkee Kirti Man Tumbahanghe Alison Morgan Nashna Maharjan Bharat Budhathoki Dharma S. Manandhar |
| author_facet | Rajendra Karkee Kirti Man Tumbahanghe Alison Morgan Nashna Maharjan Bharat Budhathoki Dharma S. Manandhar |
| author_sort | Rajendra Karkee |
| collection | DOAJ |
| description | Nepal made impressive progress in reducing maternal mortality until 2015. Since then, progress has stagnated, coinciding with Nepal’s transition to a federation with significant devolution in health management. In this context, we conducted key informant interviews (KII) to solicit perspectives on policies responsible for the reduction in maternal mortality, reasons for the stagnation in maternal mortality, and interventions needed for a faster decline in maternal mortality. We conducted 36 KIIs and analysed transcripts using standard framework analysis methods. The key informants identified three policies as the most important for maternal mortality reduction in Nepal: the Safe Motherhood Policy, Skilled Birth Attendant Policy, and Safe Abortion Policy. They opined that policies were adequate, but implementation was weak and ineffective, and strategies needed to be tailored to the local context. A range of health system factors, including poor quality of care, were identified by key informants as underlying the stagnation in Nepal’s maternal mortality ratio, as well as a few demand-side aspects. According to key informants, to reduce maternal deaths further Nepal needs to ensure that the current family planning, birth preparedness, financial incentives, free delivery services, abortion care, and community post-partum care programmes reach marginalised and vulnerable communities. Facilities offering comprehensive emergency obstetric care need to be accessible, and in hill and mountain areas, access could be supported by establishing maternity waiting homes. Social accountability can be strengthened through social audits, role models, and empowerment of health and management committees. |
| first_indexed | 2024-12-20T15:00:22Z |
| format | Article |
| id | doaj.art-2ae301d117f448dfa81eca2dee7b682a |
| institution | Directory Open Access Journal |
| issn | 2641-0397 |
| language | English |
| last_indexed | 2024-12-20T15:00:22Z |
| publishDate | 2022-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Sexual and Reproductive Health Matters |
| spelling | doaj.art-2ae301d117f448dfa81eca2dee7b682a2022-12-21T19:36:42ZengTaylor & Francis GroupSexual and Reproductive Health Matters2641-03972022-01-0129210.1080/26410397.2021.19070261907026Policies and actions to reduce maternal mortality in Nepal: perspectives of key informantsRajendra Karkee0Kirti Man Tumbahanghe1Alison Morgan2Nashna Maharjan3Bharat Budhathoki4Dharma S. Manandhar5BP Koirala Institute of Health SciencesConsultant, Mother and Infant Research Activities (MIRA)University of MelbourneMother and Infant Research Activities (MIRA)Mother and Infant Research Activities (MIRA)Mother and Infant Research Activities (MIRA)Nepal made impressive progress in reducing maternal mortality until 2015. Since then, progress has stagnated, coinciding with Nepal’s transition to a federation with significant devolution in health management. In this context, we conducted key informant interviews (KII) to solicit perspectives on policies responsible for the reduction in maternal mortality, reasons for the stagnation in maternal mortality, and interventions needed for a faster decline in maternal mortality. We conducted 36 KIIs and analysed transcripts using standard framework analysis methods. The key informants identified three policies as the most important for maternal mortality reduction in Nepal: the Safe Motherhood Policy, Skilled Birth Attendant Policy, and Safe Abortion Policy. They opined that policies were adequate, but implementation was weak and ineffective, and strategies needed to be tailored to the local context. A range of health system factors, including poor quality of care, were identified by key informants as underlying the stagnation in Nepal’s maternal mortality ratio, as well as a few demand-side aspects. According to key informants, to reduce maternal deaths further Nepal needs to ensure that the current family planning, birth preparedness, financial incentives, free delivery services, abortion care, and community post-partum care programmes reach marginalised and vulnerable communities. Facilities offering comprehensive emergency obstetric care need to be accessible, and in hill and mountain areas, access could be supported by establishing maternity waiting homes. Social accountability can be strengthened through social audits, role models, and empowerment of health and management committees.http://dx.doi.org/10.1080/26410397.2021.1907026safe motherhoodmaternal mortalitypoliciesinterventionsstrategiesnepal |
| spellingShingle | Rajendra Karkee Kirti Man Tumbahanghe Alison Morgan Nashna Maharjan Bharat Budhathoki Dharma S. Manandhar Policies and actions to reduce maternal mortality in Nepal: perspectives of key informants Sexual and Reproductive Health Matters safe motherhood maternal mortality policies interventions strategies nepal |
| title | Policies and actions to reduce maternal mortality in Nepal: perspectives of key informants |
| title_full | Policies and actions to reduce maternal mortality in Nepal: perspectives of key informants |
| title_fullStr | Policies and actions to reduce maternal mortality in Nepal: perspectives of key informants |
| title_full_unstemmed | Policies and actions to reduce maternal mortality in Nepal: perspectives of key informants |
| title_short | Policies and actions to reduce maternal mortality in Nepal: perspectives of key informants |
| title_sort | policies and actions to reduce maternal mortality in nepal perspectives of key informants |
| topic | safe motherhood maternal mortality policies interventions strategies nepal |
| url | http://dx.doi.org/10.1080/26410397.2021.1907026 |
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