Journal articles on the topic 'Childbirth Nepal'
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Regmi, Kiran, and Jeanne Madison. "Contemporary childbirth practices in Nepal: improving outcomes." British Journal of Midwifery 17, no. 6 (June 2009): 382–87. http://dx.doi.org/10.12968/bjom.2009.17.6.42608.
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Bhandari, Tulsi Ram, Shreejana Wagle, and Ganesh Dangal. "Practices and Women’s Perceptions of Childbirth in Western Nepal: A Qualitative Study." Journal of Nepal Health Research Council 18, no. 1 (April 20, 2020): 64–69. http://dx.doi.org/10.33314/jnhrc.v18i1.2413.
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Background: Despite continuous efforts to increase the utilization of institutional delivery care services nearly two-fifths women deliver their babies at home without the assistance of skilled birth attendants (SBA) in Nepal. The skilled care at birth can reduce the high maternal and neonatal mortality. This study explored childbirth practices and women’s perceptions of childbirth and its associated factors.Methods: An exploratory study was conducted in three purposively selected remote villages of Kapilvastu district, from March to May 2017. Face-to-face in-depth interviews were conducted with women who had an under-one year child. We performed a thematic analysis to draw the findings of the study. Results: Women sought institutional delivery care either for long labor-pain or obstructed-delivery. Despite various incentives, people still preferred home for normal deliveries. There was also practiced skilled birth attendant (SBA) assisted home delivery care. Some of the local health workers also advised pregnant-women for assisted home delivery care. People considered childbirth as a normal process. Due to cultural beliefs and norms, people were also reluctant to pursue institutional delivery care services. Financial constraints, poor access to services and expensive transportation services were other underlining causes of home delivery practices. Conclusions: Despite various incentives for institutional delivery care; the study did not spectacle an encouraging reaction. It pointed to the very basic and strong relationship between women’s position in the household and the society and education with childbirth practices. There were limits to how far financial incentives can overcome these obstacles. So, the improvement of the socio-economic conditions of the women would be the viable way-out of the problem.Keywords: Childbirth practices; home delivery; institutional delivery; women’s perception
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Parajuli, Bijaya. "COVID- 19 Pandemic and its Effect on Pregnancy in Nepal: A Public Health Issue." Journal of Health and Allied Sciences 11, no. 1 (August 18, 2021): 86–88. http://dx.doi.org/10.37107/jhas.200.
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World Health Organization declared Corona Virus Disease (COVID-19) that was originated from Wuhan, China as a Public Health Emergency of International Concern. The world is facing unprecedented test due to the ongoing COVID-19 pandemic. The scenario of Nepal reflects that in present condition where country is fighting with COVID- 19, safe pregnancy is not guaranteed and fear of challenges to ensure the lives of mother and children is seen among pregnant women. In particular, this has been especially major problem for pregnant women, who fear not only for themselves but often even more so for their unborn infants. Three Nepali mothers still die daily at childbirth and at least 24 women had died of birth-related complications during first two months of lockdown in Nepal. The situation is worse in remote areas where hospitals are few and far between and communities are coupled with a lack of awareness about reproductive healthcare. Thus, Nepal government should seriously address these issues because it is said that the pregnant women are the vulnerable groups during emergencies, disaster and disease outbreak. Also living in a healthy environment is ascribed as a right of people in the constitution of Nepal 2015.
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Thapa, Narbada, Virasakdi Chongsuvivatwong, Alan F. Geater, and Magnar Ulstein. "High-Risk Childbirth Practices in Remote Nepal and Their Determinants." Women & Health 31, no. 4 (April 6, 2001): 83–97. http://dx.doi.org/10.1300/j013v31n04_06.
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Sapkota, Sabitri, Toshio Kobayashi, and Miyuki Takase. "Husbands’ experiences of supporting their wives during childbirth in Nepal." Midwifery 28, no. 1 (February 2012): 45–51. http://dx.doi.org/10.1016/j.midw.2010.10.010.
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Simkhada, Bibha, Edwin Van Teijlingen, Jillian Ireland, and Padam Simkhada. "Mental Health Issues in Pregnancy and Childbirth: A Review of the Nepalese Nursing Curricula." Journal of Manmohan Memorial Institute of Health Sciences 7, no. 1 (December 1, 2021): 73–86. http://dx.doi.org/10.3126/jmmihs.v7i1.43152.
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Background: Mental health is a difficult public health topic to talk about making it hard for frontline health workers especially countries like in Nepal. General Nurses are providing maternal and mental health care due to lack of midwives and specialist mental health nurses.
Aim: This is the first study of this kind to review curricula on mental health components of pre-registration nursing training in Nepal.
Methods: We conducted a rapid review of the nursing curricula on mental health and maternity care issues in Nepal. We reviewed 10 Nursing curricula of different levels of nursing. Content analysis tool was used to extract mental health related words or concepts to analyze the nursing curriculum.
Findings: There is basic material included on both mental health and maternity care but nothing or little on the combination of the two topics. There appears to be a need for more communication skill, teaching and counseling at all levels of nursing. The nursing training need to focus on competency based and evidence based practice as successful strategies for perinatal mental health care. There is a great need for a curriculum to facilitate relevant training in Nepal.
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Xu, Shelly, Cyril Blavo D.O., Sujan Babu Marahatta, Mayur Banjara, Rakchya Amatya, Patrick Hardigan, and Nadia Anderson. "Assessment of Healthcare Utilization among Women Experiencing Childbirth in Suburban Nepal." Journal of Health Promotion 7 (September 6, 2019): 53–64. http://dx.doi.org/10.3126/jhp.v7i0.25497.
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The postnatal period (birth to 6 weeks of age) is a high-risk period for mothers and their newborns. Despite significant improvements in the Nepalese healthcare system over the last decade, there is still a high incidence of maternal and neonatal deaths during the postnatal period. These factors, in addition to existing socioeconomic barriers, discourage many women from returning to these facilities for postnatal care. This study therefore, aims to determine the extent of healthcare utilization among women with recent childbirth experience in the Mahalaxmi municipality in the Lalitpur district of Nepal. This study is descriptive cross-sectional needs assessment utilizing a pre-tested survey instrument administered to ninety-eight women who were randomly selected from the semi-urban Mahalaxmi municipality. All the respondents reported that they received ante-natal care during their pregnancy. A majority of the women reported that they received perinatal care from physicians. The results of the study showed that although there was a significantly high utilization of ante-natal and perinatal care among women with recent childbirth experience, most of the women were unaware of the availability or necessity of postnatal care, despite the accessibility of physicians and healthcare facilities.
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Gautam Bhattarai, Saraswoti Kumari, Kamala Dhakal, Apsara Pandey, and Kanchan Gautam. "Care Perception of Postnatal Mother on Care during Labour in Tertiary Level Hospital, Nepal." Journal of Advanced Academic Research 8, no. 1 (June 22, 2021): 22–32. http://dx.doi.org/10.3126/jaar.v8i1.38410.
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Background: Labour and delivery experience is one of the most significant events in a woman’s life. Support in labour has an impact on the childbirth experience and childbirth outcomes. A positive childbirth experience can help in mastering the major change in life. Therefore, the objective of this study was to find out postnatal mothers' perception on care during labour.
Methods: A descriptive cross-sectional design was used to explore the perception on care during labour of postnatal mothers in postnatal ward Tribhuvan University Teaching Hospital. Total 294 postnatal mothers with normal delivery were selected by purposive sampling method after receiving ethical approval from research department of Institute of Medicine and concerned authority. Data was analyzed by using descriptive as well as inferential statistics.
Results: Among 294 women; 208(70.75%) were received care on infection prevention, 160(54.42%) received bladder care, 175(59.66%) received care on hydration maintenance, 149(50.57%) received care on injury prevention, 103(34.88%) care on comfort measures, 180(61.14%) care on information, 207(70.54%) care on emotional support, and 201(68.31%) care immediately after childbirth. There is significant relationship among different types of care during labour (such as emotional support (44.44%), infection prevention care (19.7%), care for bladder empty (14.5%), maintenance of hydration (17.1%), care for prevention of injury (31.9%), care on pain relieve and comfort measures (50.1%), informational care (64.5%), and care immediately after delivery (18.5%)) and overall perception on care during labour. The perception level was based on mean score and was categorized as; below 3 is negative perception, 3 and above is positive perception. The finding of this study shows that 93(31.6%) postnatal mothers were perceived care negatively and 201(68.4%) perceived care positively during labour. It indicates that care during labour needs to be improved for best care perception.
Conclusions: Women expect professional, supportive and respectful care during labour. Continuous care and support during labour has meaningful benefits for women and infants. It indicates that the care during labour need to be improved for best care perception.
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Simkhada, Bibha, Geeta Sharma, Samridhi Pradhan, Edwin Van Teijlingen, Jillian Ireland, Padham Simkhada, and Bhimsen Devkota. "Needs assessment of mental health training for Auxiliary Nurse Midwives: a cross-sectional survey." Journal of Manmohan Memorial Institute of Health Sciences 2 (September 26, 2016): 20–26. http://dx.doi.org/10.3126/jmmihs.v2i0.15793.
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Mental health in pregnant women and new mothers is increasing recognised on the global health agenda. In Nepal mental health is generally a difficult to topic to discuss. THET, a London-based organisation, funded Bournemouth University, and Liverpool John Moores University in the UK and Tribhuvan University in Nepal to train community-based maternity workers on issues around mental health.This paper reports on a quantitative survey with nearly all Auxiliary Nurse Midwives in Nawalparasi (southern part of Nepal). The findings illustrate the lack of training on mental health issues related to pregnancy and childbirth in this group of health workers. Thus the paper’s conclusions stress the need for dedicated training in this field.Journal of Manmohan Memorial Institute of Health Sciences Vol. 2 2016 p.20-26
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Dhakal Rai, Sulochana, Pramod Raj Regmi, Edwin van Teijlingen, Juliet Wood, Ganesh Dangal, and Keshar Bahadur Dhakal. "Rising Rates of Caesarean Section in Urban Nepal." Journal of Nepal Health Research Council 16, no. 41 (January 28, 2019): 479–80. http://dx.doi.org/10.33314/jnhrc.v16i41.1750.
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The rising rate of caesarean section in urban Nepal is alarming as the lack of access for women in rural areas to emergency obstetric care, putting lives at risk. The latter is referred to as ‘Too little too late’. At the same time, the sharp rise in caesarean section rates in cities presents the other extreme: “Too much too soon”. The overuse of caesarean section causes harm, unnecessary costs, and misuse of health resources. Availability of private hospitals and increasing hospital childbirth may contribute to the rising rate of caesarean section. This article highlights the rising rate of caesarean section in urban Nepal.Keywords: Caesarean section; emergency obstetric care; Nepal.
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Regmi, K. "O793 Childbirth in rural Nepal: influence of mothers-in-law and patriarchy." International Journal of Gynecology & Obstetrics 107 (October 2009): S320. http://dx.doi.org/10.1016/s0020-7292(09)61166-8.
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Sanjel, Keshab, and Archana Amatya. "Determinants of Timely Initiation of Breastfeeding among Disadvantaged Ethnic Groups in Midwest Nepal." Journal of Nepal Health Research Council 16, no. 41 (January 28, 2019): 385–91. http://dx.doi.org/10.33314/jnhrc.v16i41.1591.
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Background: Timely initiation of breastfeeding has the potential to prevent 22% of neonatal deaths if breastfed within an hour after birth. Although breastfeeding is almost universal in Nepal, ranges of regional differences in timely initiation of breastfeeding have been documented. The aim of this study was to identify the prevalance and the determinants of early initiation of breastfeeding among disadvantaged ethnic women in Midwest Nepal. Methods: The data was obtained from a household survey of women who had their last child less than one year of age. Descriptive statistics were used to analyze respondents’ demographic, socioeconomic, obstetric and health services related characteristics. Determinants of timely initiation of breastfeeding were assessed using univariate analysis and further evaluated using multivariable logistic regression analysis.Results: Of 362 mothers, 65.5% initiated breastfeeding within one hour of childbirth. Mothers belonging to Tharu ethnic groups (aOR 1.788; 95% CI: 1.014, 3.152), health facility delivery (aOR 3.381; 95% CI: 1.795, 6.369) and mothers who were counseled on breastfeeding during ANC attendance (aOR 2.898; 95% CI: 1.038, 8.096) were more likely to initiate breastfeeding within the first hour of child birth. Conclusions: Almost two in every three mothers had initiated breastfeeding within one hour of childbirth. The factors influencing timely initiation of breastfeeding were Tharu ethnic mothers, health facility delivery and Ante Natal Care counseling. We need to aim at increasing institutional deliveries and counseling during ANC which may increase the early initiation of breastfeeding among disadvantaged ethnic groups. Keywords: Breastfeeding; determinants; Nepal; prevalence; timely initiation
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Bhandari, Sushila Devi, and Sarala Joshi. "Perception and Perceived Experiences about Prevention and Consequences of Teenage Pregnancy and Childbirth among Teenage Mothers: A Qualitative Study." Journal of Advanced Academic Research 3, no. 1 (February 11, 2017): 164–72. http://dx.doi.org/10.3126/jaar.v3i1.16625.
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Teenage pregnancy and childbirth is a social problem in many Asian countries including Nepal. Many quantitative studies have been done on teenage pregnancy, its outcomes, and challenges faced by teenager, but very little are known about their perceptions and experiences about teenage pregnancy and their consequences during childbirth. This study aimed to explore the perceptions and experiences of teenage pregnancy and childbirth among teenage mothers. This study has adopted phenomenology approach to explore the perceptions and experiences of being a teen mother. Study was based on data collected through in-depth interviews (IDIs), and Focus Group Discussion (FGDs). All respondents provided verbal as well as written consent to face the interview. IDI guide was used to collect information among teenage mothers to assess their perception and experiences on teenage pregnancy and childbirth. Similar guide was used for FGDs. Collected information was manually processed through qualitative content analysis and grouped into theme and subthemes. The teenage mother understood that teenage pregnancy and childbirth is a risk for both mother and child. A majority of them perceived that low education, poverty, love marriage, family problems, in-laws pressure; cultural prospects are aggravating factors leading to teenage pregnancy. Almost all of the respondents mentioned the negative impact of teenage pregnancy on the health. But very few respondents knew advantages of teenage childbirth. Most of them however knew that the teenage pregnancy can be prevented. Access to family planning services to teenage mothers, community awareness, and government support is needed to reduce teenage pregnancy and childbirth.
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Parajuli, Surya Bahadur, Heera KC, Seema Kumari Mishra, and Anish Luitel. "Quality of Life among Postmenopausal Women: A Community-based Cross-sectional Study." Journal of BP Koirala Institute of Health Sciences 4, no. 2 (December 31, 2021): 35–40. http://dx.doi.org/10.3126/jbpkihs.v4i2.40843.
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Background: Postmenopausal women have various problems that may affect their quality of life. However, published reports from nearby communities of the capital of province 1 of Nepal are lacking. Hence, we aimed to determine the quality of life of postmenopausal women in selected communities of Morang, Nepal. Methods: This cross-sectional study was conducted from August to October 2021 among 200 postmenopausal women of Budhiganga Rural Municipality. Menopause-specific quality of life (MENQoL) that included vasomotor, psychological, physical, and sexual domains was assessed. Factors that may affect it were also assessed. Results: Majority of the participants had sweating (80.5%), accomplishing less than earlier (95.0%), decrease in physical strength, feeling lack of energy (98.1%), and avoiding intimacy (98.5%) in vasomotor, psychosocial, physical, and sexual domains respectively. The highest mean score was found in the sexual (5.02 ± 0.82) followed by physical (3.43 ± 0.51), vasomotor (3.0 ± 1.08), and psychosocial domain (2.74 ± 0.80). The MENQoL score was 3.48 ± 0.53 with a significant association with age and occupation. The psychosocial domain had a significant association with age, marital status, occupation, history of childbirth, current smoking, and current alcohol use. The physical domain had a significant association with age, religion, marital status, occupation, and history of childbirth. The sexual domain had a significant association with age and current alcohol use. Conclusion: Sexual domain was the most affected in postmenopausal women followed by physical, vasomotor, and psychosocial domain. Age, occupation, marital status, history of childbirth, current smoking, and current alcohol use were the factors associated with MENQoL.
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Regmi, K., and J. Madison. "O795 Childbirth practices in Nepal: A review of models for reducing adverse outcomes." International Journal of Gynecology & Obstetrics 107 (October 2009): S321. http://dx.doi.org/10.1016/s0020-7292(09)61168-1.
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Acharya, Shusma, and Durga Bista. "Utilization of Free Maternity Services among Reproductive Age Women of Chepang Community in Nepal." International Journal of Health Sciences and Research 12, no. 1 (January 20, 2022): 236–44. http://dx.doi.org/10.52403/ijhsr.20220132.
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Background: Approximately 287,000 women died globally from causes related to pregnancy and childbirth in 2010. Nepal is among the countries with high maternal mortality rates in South Asia region with estimated Maternal Mortality Rate 239/100,000 live births. Underutilization of health services is one factor contributing to high maternal mortality rate. In Nepal, 81% of births take place at home without skilled health providers. Many complications related to childbirth can be prevented by utilization of maternal health services. Methods: A descriptive cross-sectional study was carried out among 71 respondents from May 15, 2019 to November 16, 2019 and it took by using total enumeration sampling technique. Structured self developed questionnaire was used to collect data using interview technique. Data was analyzed via SPSS software version 16 by using descriptive and inferential statistics. Results: Utilization of free maternity services was extremely low among Chepang women of Western Region of Nepal. With regards to antenatal utilization during their latest pregnancy was 73.2%. Only22.5% of the respondents had given birth of their baby in health institution rest of them delivered at home. Majority of the respondents did not utilized postnatal services (95.8%) whereas only 4.2% respondents utilized postnatal services. There was statistically significant association between utilization of ANC services and age (p=0.000), income (p= .006), education of the respondent (p=0.001) and religion of the respondents (p= 0.044). Similarly there was statistically significant association between utilization of delivery services and age (p=0.29), education of the respondent (p=0.007) but there is no significant association between utilization of postnatal services and selected demographic variables. Conclusion: The study concluded that maternity services utilization is extremely low among Chepang women of Nepal. There was significant association between age, educational status and religion. Therefore the government and non government organizations effort on health awareness programme are essential to maximize the utilization of maternity services. Key words: Antenatal, Delivery, Chepang, Postnatal, Utilization.
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Ikeda, Subaru, Akira Shibanuma, Ram Silwal, and Masamine Jimba. "Factors associated with the length of stay at health facilities after childbirth among mothers and newborns in Dhading, Nepal: a cross-sectional study." BMJ Open 11, no. 5 (May 2021): e042058. http://dx.doi.org/10.1136/bmjopen-2020-042058.
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ObjectiveTo measure the length of stay at a health facility after childbirth, identify factors associated with the length of stay and measure the gap between the timings of the last check-up and discharge.DesignA cross-sectional study.SettingFive public health facilities in Dhading, Nepal.Participants351 randomly selected mothers who gave birth at selected health facilities within 1 year of data collection between 10 and 31 August 2018.Outcome measureLength of stay (hours) at a health facility after childbirth. Adequate length was defined as 24 hours or longer based on the WHO guidelines.ResultsAmong 350 mothers (99.7%) out of 351 recruited, 61.7% were discharged within 24 hours after childbirth. Factors associated with shorter length of stay were as follows: travel time less than 30 min to a health facility (incidence rate ratio (IRR)=0.69, 95% CI 0.61 to 0.78); delivery attended by auxiliary staff (IRR=0.86, 95% CI 0.75 to 0.98); and delivery in a primary healthcare centre (IRR=0.67, 95% CI 0.58 to 0.79). Factors associated with longer length of stay were as follows: aged 22 years or above at the first pregnancy (IRR=1.25, 95% CI 1.13 to 1.40); having maternal complications (IRR=2.41, 95% CI 2.16 to 2.70); accompanied by her own family (IRR=1.17, 95% CI 1.03 to 1.34), accompanied by her husband (IRR=1.16, 95% CI 1.04 to 1.29); and delivered at a facility with a physical space where mother and newborn could stay overnight (IRR=1.20, 95% CI 1.07 to 1.34). Among mothers without complications, 32% received the last check-up 3 hours or less before discharge.ConclusionsMultiple factors, such as mothers’ conditions, health facility characteristics and external support, were associated with the length of stay after childbirth. However, even if mothers stayed long, they might have not necessarily received timely and proper assessment before discharge.
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Johnson, J., S. Kristensen, A. Samen, S. Craig, and T. Dye. "Men's attitudes, beliefs and roles in pregnancy and childbirth: an Ethnographic Study in Nepal." Contraception 88, no. 3 (September 2013): 450–51. http://dx.doi.org/10.1016/j.contraception.2013.05.080.
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Bhusal, C. K., and S. Bhattarai. "Involvement of male in birth preparedness in Tulsipur municipality of Dang district, Nepal." Journal of Chitwan Medical College 5, no. 4 (February 15, 2017): 33–38. http://dx.doi.org/10.3126/jcmc.v5i4.16550.
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Male in patriarchal societies of developing countries are identified as decision makers in all aspects of life. Every pregnant woman faces risk of life-threatening obstetric complications. A birth-preparedness package promotes active preparation and assists in decision-making for healthcare seeking in case of such complications. The present study attempted to assess the involvement of male in birth preparedness in Tulsipur Municipality of Dang District. A Descriptive Cross Sectional Study was conducted among 125 male including husbands of pregnant women and fathers of under one children in 2011, to assess the involvement of male in birth preparedness. Purposively record was reviewed from the Rapti Zonal Hospital as well as Municipality office, and respondent were identified using snowball sampling from community. More than half 52.8% of the respondents heard about Birth Preparedness. Nearly half 44.36% of the respondents plan for preparedness of birth, more than half 56.8% had thought to plan if emergency situation or complication arises during pregnancy and childbirth. Most 69.6% of the respondent has planned the place for giving birth to their child. Nearly half 51.8 % of respondent have plan for visiting their wives to Skill Birth Attendants. Only few 12.5% of the husbands had planned for transportation facility and identified Blood Donors if required’. About half 48% of the husbands are accompanying their wife for Antenatal Care. Most 88% of the husbands help their wives in household activities during pregnancy and childbirth. It shows that about half of the male were involved in Birth Preparedness.
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Tiwari, Aparna, Aradhana Thapa, Nandini Choudhury, Rekha Khatri, Sabitri Sapkota, Wan-Ju Wu, Scott Halliday, et al. "A Type II hybrid effectiveness-implementation study of an integrated CHW intervention to address maternal healthcare in rural Nepal." PLOS Global Public Health 3, no. 1 (January 24, 2023): e0001512. http://dx.doi.org/10.1371/journal.pgph.0001512.
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Skilled care during pregnancy, childbirth, and postpartum is essential to prevent adverse maternal health outcomes, yet utilization of care remains low in many resource-limited countries, including Nepal. Community health workers (CHWs) can mitigate health system challenges and geographical barriers to achieving universal health coverage. Gaps remain, however, in understanding whether evidence-based interventions delivered by CHWs, closely aligned with WHO recommendations, are effective in Nepal’s context. We conducted a type II hybrid effectiveness-implementation, mixed-methods study in two rural districts in Nepal to evaluate the effectiveness and the implementation of an evidence-based integrated maternal and child health intervention delivered by CHWs, using a mobile application. The intervention was implemented stepwise over four years (2014–2018), with 65 CHWs enrolling 30,785 families. We performed a mixed-effects Poisson regression to assess institutional birth rate (IBR) pre-and post-intervention. We used the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework to evaluate the implementation during and after the study completion. There was an average 30% increase in IBR post-intervention, adjusting for confounding variables (p<0.0001). Study enrollment showed 35% of families identified as dalit, janjati, or other castes. About 78–89% of postpartum women received at least one CHW-counseled home visit within 60 days of childbirth. Ten (53% of planned) municipalities adopted the intervention during the study period. Implementation fidelity, measured by median counseled home visits, improved with intervention time. The intervention was institutionalized beyond the study period and expanded to four additional hubs, albeit with adjustments in management and supervision. Mechanisms of intervention impact include increased knowledge, timely referrals, and longitudinal CHW interaction. Full-time, supervised, and trained CHWs delivering evidence-based integrated care appears to be effective in improving maternal healthcare in rural Nepal. This study contributes to the growing body of evidence on the role of community health workers in achieving universal health coverage.
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Baral, Gehanath, Alish Shrestha, Arati Sah, and Aswani Kumar Gupta. "Robsons Ten Group Classification of Cesarean Section at a Tertiary Center in Nepal." Journal of Nepal Health Research Council 19, no. 1 (April 23, 2021): 91–96. http://dx.doi.org/10.33314/jnhrc.v19i1.2694.
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Background: Increasing trend in Ceasarean birth is the issue of both demand and supply side. One of the recommended tools to characterize every pregnancy admitted for childbirth is Robson ten-group classification system that may evaluate obstetric practice. The aim of the study was to assess the cesarean section pattern based on Robson’s classification in a central referral hospital.Methods: A retrospective census of childbirths at Paropakar Maternity and Women’s Hospital in Kathmandu performed from September 2018 to February 2019 based on obstetric record. Robson ten-group classification system was the research tool to collect data and Robson Classification Report Table was used to evaluate the data.Results: There were 10500 births with 34% (32-35%) overall cesarean section rate. Excluding spontaneous and induced labor the supposedly total prelabor CS is 14.5%. Group 1+2+3 size is 81% and 21% CS; 5+10 had 11.3% and 23.3% respectively. Prelabor CS (2b+4b) is 3.54% and additional 11% from malpresentation and preterm. Group CS rate from Class 5 onwards, and ratio of 1 and 2 are as recommended by Robson; 67% of CS were not picked up by Robson class due to indications evolved as the labor progresses and the attributes not pre-classified.Conclusions: The assessed quality of data and the type of obstetric population by Robson reference values prove this study as a representative research. But the indications of cesarean sections can be predicted for only one-third of pregnancy attributes classified by Robson class. To supplement this tool to reduce rising cesarean birth requires audit of indications at decision making level.Keywords: Cesarean section; indication; prediction; robson classification
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MacRorie, R. A. "Births, Deaths and Medical Emergencies in the District: A Rapid Participatory Appraisal in Nepal." Tropical Doctor 28, no. 3 (July 1998): 162–65. http://dx.doi.org/10.1177/004947559802800312.
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Two qualitative rapid appraisal techniques were used in a community-based study to investigate health beliefs, attitudes and practices in a rural district in Nepal. Pregnancy and childbirth remain non-medical activities managed at home. Deaths may be avoided by better access to hospital emergency services. Health awareness of some problems, e.g. oral rehydration in diarrhoeal disease, is high; but of others, e.g. association of haemoptysis with tuberculosis, is poor. These methods require few resources, are efficient in time and manpower required, and generate useful relevant information on a target population. They are recommended for district health development programmes elsewhere.
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Bhattarai, Saraswoti Kumari Gautam, and Kanchan Gautam. "Quality of Maternity Care and Client Satisfaction." Journal of Karnali Academy of Health Sciences 2, no. 1 (June 11, 2019): 73–76. http://dx.doi.org/10.3126/jkahs.v2i1.24419.
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Health service provided to pregnant women during antenatal, childbirth and postnatal period is essential for maternal and child health. Proper care during pregnancy, childbirth and postnatal period are important for the health of mother and baby. High maternal, infant and child morbidity and mortality demand improved healthcare which does not concern to coverage of health services alone. The health issues of pregnant women, mothers, infants and children need to be addressed with the attention to the quality of care (QoC). The Nepal Health Sector Strategy (NHSS) also identifies equity and quality of care gaps as areas of concern for achieving the maternal health sustainable development goal (SDG) target. So this review aims to sensitize and draw attention to the quality of maternity care and client satisfaction to improve maternal and child health. For this article, different studies related to the quality of maternity care and satisfaction from care service received on maternity care are reviewed.
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Dulal, Momal Prasad. "Maternal Health Care Service Utilization and Its Role in Postpartum Family Planning Use in Nepal." Journal of Management and Development Studies 26 (September 3, 2015): 79–91. http://dx.doi.org/10.3126/jmds.v26i0.24943.
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Family planning and maternal health care programme has been initiated in an integrated approach for a long time in Nepal. However, the use status of family planning method could not be presented at good instance. The International Conference on Population and Development (ICPD), 1994 and later millennium development goal 2002, both paved the way out for the situation mostly in the developing countries. Nepal also has made some changes in its services aiming to reduce high maternal mortality and promote to use family planning method. Use of family planning method within 12 months after childbirth could be a right solution for many developing countries like Nepal having high unintended birth. Therefore, this paper aims to analyse the role of maternal health care service utilization in initiating use of family planning method after post-partum period. Women’s data file from Nepal Demographic Health Survey, 2011 has been used for the analysis. Bivariate and multivariate analysis result have revealed that the role of delivery care, controlling other variables seems to be much appreciable in getting family planning use within 12 months of delivery. Effects of some study variables besides delivery care remains unchanged in different models. Therefore, embracing family planning programme along with maternity care components would have implications towards - increasing current use of family planning, reducing the chances of unwanted/unintended birth, providing opportunities to control over female own body, contribution in achieving replacement level fertility and maintaining good health for both mother and the baby.
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Khatri, Resham Bahadur, Tara Prasad Dangi, Rupesh Gautam, Khadka Narayan Shrestha, and Caroline S. E. Homer. "Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study." PLOS ONE 12, no. 5 (May 11, 2017): e0177602. http://dx.doi.org/10.1371/journal.pone.0177602.
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Pun, Kunta Devi, Poonam Rishal, Jennifer Jean Infanti, Johan Håkon Bjørngaard, Rajendra Koju, Berit Schei, and Elisabeth Darj. "Exposure to domestic violence influences pregnant women’s preparedness for childbirth in Nepal: A cross-sectional study." PLOS ONE 13, no. 7 (July 26, 2018): e0200234. http://dx.doi.org/10.1371/journal.pone.0200234.
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Rajbhandari, Swaraj, Stephen Hodgins, Harshad Sanghvi, Robert McPherson, Yasho V. Pradhan, and Abdullah H. Baqui. "Expanding uterotonic protection following childbirth through community-based distribution of misoprostol: Operations research study in Nepal." International Journal of Gynecology & Obstetrics 108, no. 3 (January 19, 2010): 282–88. http://dx.doi.org/10.1016/j.ijgo.2009.11.006.
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K. C., Ashish, Md Moinuddin, Mary Kinney, Emma Sacks, Rejina Gurung, Avinash K. Sunny, Pratiksha Bhattarai, Srijana Sharma, and Mats Målqvist. "Mistreatment of newborns after childbirth in health facilities in Nepal: Results from a prospective cohort observational study." PLOS ONE 16, no. 2 (February 17, 2021): e0246352. http://dx.doi.org/10.1371/journal.pone.0246352.
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Background Patient experience of care reflects the quality of health care in health facilities. While there are multiple studies documenting abuse and disrespect to women during childbirth, there is limited evidence on the mistreatment of newborns immediately after childbirth. This paper addresses the evidence gap by assessing the prevalence and risk factors associated with mistreatment of newborns after childbirth in Nepal, based on a large-scale observational study. Methods and findings This is a prospective observational cohort study conducted over a period of 18 months in 4 public referral hospitals in Nepal. All newborns born at the facilities during the study period, who breathed spontaneously and were observed, were included. A set of indicators to measure mistreatment for newborns was analysed. Principal component analysis was used to construct a single newborn mistreatment index. Uni-variate, multi-variate, and multi-level analysis was done to measure the association between the newborn mistreatment index and demographic, obstetric, and neonatal characteristics. A total of 31,804 births of newborns who spontaneously breathed were included. Among the included newborns, 63.0% (95% CI, 62.5–63.5) received medical interventions without taking consent from the parents, 25.0% (95% CI, 24.5–25.5) were not treated with kindness and respect (roughly handled), and 21.4% (95% CI, 20.9–21.8) of them were suctioned with no medical need. Among the newborns, 71.7% (95% CI, 71.2–72.3) had the cord clamped within 1 minute and 77.6% (95% CI, 77.1–78.1) were not breast fed within 1 hour of birth. Only 3.5% (95% CI, 3.2–3.8) were kept in skin to skin contact in the delivery room after birth. The mistreatment index showed maximum variation in mistreatment among those infants born to women of relatively disadvantaged ethnic groups and infants born to women with 2 or previous births. After adjusting for hospital heterogeneity, infants born to women aged 30–34 years (β, -0.041; p value, 0.01) and infants born to women aged 35 years or more (β, -0.064; p value, 0.029) were less mistreated in reference to infants born to women aged 18 years or less. Infants born to women from the relatively disadvantaged (chhetri) ethnic groups (β, 0.077; p value, 0.000) were more likely to be mistreated than the infants born to relatively advantaged (brahmin) ethnic groups. Female newborns (β, 0.016; p value, 0.015) were more likely to be mistreated than male newborns. Conclusions The mistreatment of spontaneously breathing newborns is high in public hospitals in Nepal. Mistreatment varied by hospital, maternal ethnicity, maternal age, and sex of the newborn. Reducing mistreatment of newborns will require interventions at policy, health system, and individual level. Further, implementation studies will be required to identify effective interventions to reduce inequity and mistreatment of newborns at birth.
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Rajbanshi, Sushma, Mohd Noor Norhayati, and Nik Hussain Nik Hazlina. "High-risk pregnancies and their association with severe maternal morbidity in Nepal: A prospective cohort study." PLOS ONE 15, no. 12 (December 28, 2020): e0244072. http://dx.doi.org/10.1371/journal.pone.0244072.
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Background The early identification of pregnant women at risk of developing complications at birth is fundamental to antenatal care and an important strategy in preventing maternal death. This study aimed to determine the prevalence of high-risk pregnancies and explore the association between risk stratification and severe maternal morbidity. Methods This hospital-based prospective cohort study included 346 pregnant women between 28–32 gestational weeks who were followed up after childbirth at Koshi Hospital in Nepal. The Malaysian antenatal risk stratification approach, which applies four color codes, was used: red and yellow denote high-risk women, while green and white indicate low-risk women based on maternal past and present medical and obstetric risk factors. The World Health Organization criteria were used to identify women with severe maternal morbidity. Multivariate confirmatory logistic regression analysis was performed to adjust for possible confounders (age and mode of birth) and explore the association between risk stratification and severe maternal morbidity. Results The prevalence of high-risk pregnancies was 14.4%. Based on the color-coded risk stratification, 7.5% of the women were categorized red, 6.9% yellow, 72.0% green, and 13.6% white. The women with high-risk pregnancies were 4.2 times more likely to develop severe maternal morbidity conditions during childbirth. Conclusions Although smaller in percentage, the chances of severe maternal morbidity among high-risk pregnancies were higher than those of low-risk pregnancies. This risk scoring approach shows the potential to predict severe maternal morbidity if routine screening is implemented at antenatal care services. Notwithstanding, unpredictable severe maternal morbidity events also occur among low-risk pregnant women, thus all pregnant women require vigilance and quality obstetrics care but high-risk pregnant women require specialized care and referral.
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Anand, Enu, Sayeed Unisa, and Jayakant Singh. "INTIMATE PARTNER VIOLENCE AND UNINTENDED PREGNANCY AMONG ADOLESCENT AND YOUNG ADULT MARRIED WOMEN IN SOUTH ASIA." Journal of Biosocial Science 49, no. 2 (June 21, 2016): 206–21. http://dx.doi.org/10.1017/s0021932016000286.
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SummaryThis study examined the relationship between Intimate Partner Violence (IPV) and unintended pregnancy among young women in South Asia using Demographic and Health Survey data from India (2005–2006), Bangladesh (2007) and Nepal (2011). The respondents were adolescent and young adult married women aged 15–24 years who had at least one childbirth in the five years preceding the survey. Bivariate and stepwise multivariate logistic regression analyses were performed to assess the relationship between IPV and unintended pregnancy. Thirty-eight per cent of the respondents in India, 52% in Bangladesh and 28% in Nepal reported having experienced physical or sexual IPV. Those who reported physical or sexual IPV had higher odds of unintended pregnancy (1.36 in India and 1.99 in Bangladesh). The findings indicate that IPV is a risk factor for unintended pregnancy among adolescent and young adult married women. Along with violence prevention programmes, a more responsive and youth-friendly health system needs to be in place to provide health care services to young women in these countries.
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Thapa, Pratibha, Amod Poudyal, Rajan Poudel, Dipak Prasad Upadhyaya, Ashish Timalsina, Rama Bhandari, Jijeebisha Baral, et al. "Prevalence of low birth weight and its associated factors: Hospital based cross sectional study in Nepal." PLOS Global Public Health 2, no. 11 (November 2, 2022): e0001220. http://dx.doi.org/10.1371/journal.pgph.0001220.
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Low birth weight is still an important public health problem worldwide. It is a major contributor to neonatal death in developing countries, including Nepal. The government of Nepal has developed and implemented different programs to improve maternal and neonatal health, including baby’s birth weight. However, low birth weight is a major maternal and child health challenge. Maternal factors determining the birth weight of neonates have been poorly assessed in previous studies in Nepal. Thus, this study aims to assess the prevalence and risk factors associated with low birth weight in Nepal. An institution-based descriptive cross-sectional study was carried out in Paropakar Maternity Hospital and Tribhuvan University Teaching Hospital of Kathmandu district among 308 postnatal mothers. The data was collected through the face-to-face interview technique. The data was entered in EpiData 3.1 and exported to Statistical Package and Service Solutions version 21 for analysis. Multivariate logistic regression was used to obtain an adjusted odds ratio, while p-value < 0.05 with 95% Confidence Interval (CI) was considered significant. The findings showed that 15.3% of the children had low birth weight. The mean and standard deviation of childbirth weight was 2.96±0.59 kg. Mothers belonged to Dalit ethnic (AOR = 2.9, 95% CI = 1.2–7.1), Antenatal Care visited three or fewer (AOR = 2.6, 95%CI = 1.0–6.6) and did not comply with Iron and Folic Acid supplementation (AOR = 2.1, 95% CI = 1.0–4.4) were significantly associated with low birth weight. Nearly one in every six children had low birth weight. Maternal health services such as antenatal care and compliance with a recommended dose of maternal micronutrients significantly impact on birth weight. Maternal and neonatal health programs should consider these factors to reduce adverse birth outcomes in Nepal.
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Tamang, Jonu Pakhrin, Rhysa McNeil, and Phattrawan Tongkumchum. "Factors Associated with Non-Institutional Delivery among Pregnant Women in Nepal." Asian Social Science 15, no. 7 (June 30, 2019): 43. http://dx.doi.org/10.5539/ass.v15n7p43.
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Delivery location may influence maternal morbidity and mortality, especially in developing countries such as Nepal. The aim of this study was to determine factors associated with place of delivery among pregnant women in Nepal in order to inform health policy makers attempting to improve mother and child health. Data from the Multiple Indicator Cluster Survey, conducted in 2014, were retrospectively reviewed. In the survey, women aged 15-49 years were interviewed face-to-face using a structured questionnaire. Study subjects were women who had giving birth within the previous two years. A total of 2,086 women (48.9%) had non-institutional delivery (46.5% at home). Logistic regression models were used to identify significant factors influencing non-institutional delivery. Results showed that increasing educational level and wealth quintile index corresponded to a decreasing percentage of non-institutional delivery. More than half (55.5%) of women from rural areas had a non-institutional delivery. Multiparous women (57.2%) and those having less than 4 antenatal care visits (66.8%) had relatively higher rates of non-institutional delivery. In conclusion, there is a need to intensify education for pregnant women, especially those who have had previous childbirth experience. It is also crucial to target women from poor households, to increase their awareness, and promote institutional delivery.
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Bhattarai, Saraswoti Kumari Gautam, and M. Dahal. "Comprehensive Emergency Obstetrical and Neonatal Care (CEmONC) at Karnali Academy of Health Sciences, Teaching Hospital, Jumla." Journal of Karnali Academy of Health Sciences 1, no. 3 (December 31, 2018): 31–34. http://dx.doi.org/10.3126/jkahs.v1i3.24151.
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Introduction: Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries like Nepal with a high burden of maternal and newborn mortality. So this study aims to find out the status of comprehensive emergency obstetrical and neonatal care (CEmONC) service.
Method: A retrospective cross-sectional study was conducted using secondary data sources at maternity ward of KAHS teaching hospital, Jumla. Total 291 women admitted in maternity ward for childbirth were included in the study of six month period of 2075. Sampling technique was census for the study who were admitted for child birth purpose. Cases were selected from the record of the maternity ward. The data was collected by using structured tool. Ethical approval was taken from the ethical review committee of KAHS for ethical clearance. Data was analyzed by using descriptive statistics.
Result: There were 291 women admitted in the maternity ward for the purpose of childbirth during six-month period. Among them 224(76.97%) women delivered baby by spontaneous vaginal delivery; 61(20.96%) delivered with C/S and 6(2.06%) were delivered with instrumental delivery. Regarding the indication of 61 cesarean section (C/S) delivery; 22.95% with fetal distress, 16.39% with cephalopelvic disproportion and 11.47% with meconium stained liquor
Conclusions: About one third childbirth was done by cesarean section with indication of fetal distress, cephalo-pelvic disproportion and meconium stained liquor in higher proportion. Although CEONC service is effective, the rate of cesarean section can be reduced by providing good quality antenatal care.
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Ghimire, Narayani Paudel, Sunil Kumar Joshi, Pranab Dahal, and Katarina Swahnberg. "Women’s Experience of Disrespect and Abuse during Institutional Delivery in Biratnagar, Nepal." International Journal of Environmental Research and Public Health 18, no. 18 (September 12, 2021): 9612. http://dx.doi.org/10.3390/ijerph18189612.
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Worldwide, a large number of women experience disrespectful and abusive behavior from care providers during childbirth. This violates the rights of women to attain respectful care. This study aimed to find out the women’s experience of disrespect and abuse during institutional delivery. A cross-sectional study was conducted in two hospitals of Morang district situated in eastern Nepal. Two hundred eighteen women from a public hospital and 109 women from a private hospital (N = 327) with normal vaginal delivery were selected purposively for this study. Data were collected through face-to-face interviews using a structured questionnaire based on the Disrespectful and Abusive Scale by Bowser and Hill. All women had experienced at least one type of disrespect and/or abuse during labor and delivery, most common being non-consented care (100%), non-dignified care (72%), and non-confidential care (66.6%), respectively. Discriminatory care and physical abuse were experienced by 32.33% and 13.23%, respectively. Ethnicity, religion, place of delivery, and numbers of living children were the main predictors of reporting disrespect and abuse. Overall, the occurrence of disrespect and abuse during institutional delivery was found to be very high.
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Khadka, Madan, Dhruba Kumar Uprety, and Rubina Rai. "Evaluation of associated risk factors of near miss obstetrics cases at B.P. Koirala Institute of Health Sciences, Dharan, Nepal." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 2 (January 23, 2018): 408. http://dx.doi.org/10.18203/2320-1770.ijrcog20175931.
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Background: In 2011, around 273,465 women died worldwide during pregnancy, childbirth or within 42 days after childbirth. Near-miss is recognized as the predictor of level of care and maternal death. The objective of the study was to evaluate the associated risk factors of near miss obstetric cases.Methods: A prospective observational study was done from August 1, 2014 to July 30, 2015 in Department of Obstetrics and Gynecology at BPKIHS hospital, tertiary care hospital in Eastern Nepal, Dharan. Case eligible by 5 factor scoring system and WHO near miss criteria were evaluated. Risk factors included severe hemorrhage, hypertensive disorders, complication of abortion, ruptured uterus, medical/surgical condition and sepsis.Results: A total of 9,727 delivery were attended during the study period from August 2014 to July 2014. There were 6307 (71.5%) vaginal delivery and 2777 (28.5%) caesarean section and 181 perinatal death with total of 9,546 livebirth. 162 near miss and 16 maternal death occurred during the study. Maternal near miss rate of 16.6 per 1000 live birth, Women with life-threatening conditions of 172, Severe maternal outcome ratio of 18.64, Maternal near-miss: mortality ratio: 10.1:1, Mortality index: 8.98%. Risk factors were obstetric hemorrhage 27.8%, abortion/ectopic 27.2%, eclampsia 16%, medical/surgical condition 14.8%, sepsis 13.6%, severe preeclamsia 11.1%, ruptured uterus 3.1%, and molar pregnancy 1.9% and cardiovascular and coagulation dysfunction as a major life-threatening condition and sepsis (25%) was the major cause of mortality.Conclusions: Haemorrhage and hypertensive disorders are the leading causes of near miss event. Evaluation of associated risk factor can be potential tool for reduction of maternal morbity and mortality.
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Nepal, Samata, Alok Atreya, and Tanuj Kanchan. "Teenage Pregnancies in Nepal – The Problem Status and Socio-Legal Concerns." Journal of Nepal Medical Association 56, no. 211 (June 30, 2018): 678–82. http://dx.doi.org/10.31729/jnma.3571.
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Introduction: Teenage pregnancy is an issue that needs to be addressed for a better health of the women and the society. The present analysis is undertaken to find out the incidence of teenage mothers who have had hospital delivery and focuses upon the various reasons for teenage pregnancy with a brief discussion upon the associated medicolegal and social aspects.
Methods: A cross sectional study was carried out in a tertiary hospital in western region of Nepal. The delivery case register were reviewed for teenage pregnancies and the relevant data was captured in a data sheet and analysed.
Results: During the study period, a total of sixty-nine teenage pregnancies culminated into delivery/ childbirth. The mean age of teenage mother was 18.16±0.99 years. Majority of the teenage mothers had not completed their secondary education and were of low socioeconomic strata. Mode of delivery was caesarean section in thirty four cases, whereas vaginal delivery was conducted in thirty five cases. Live births accounted for 67 deliveries, a still birth case was of anencephalic foetus while the other one was a preterm which was spontaneously delivered at the 23rd weeks of gestation.
Conclusions: Education and awareness in the form of campaign, advertisements, road shows, television or radio programmes are suggested for a decline in the rate of teenage marriages and teenage pregnancies in Nepal in the days to come.
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Karki, Renuka Kumari. "Trend Analysis of Maternal Health Care Services in Nepal." Journal of Population and Development 3, no. 1 (October 10, 2022): 130–40. http://dx.doi.org/10.3126/jpd.v3i1.48812.
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This study attempts to analyze the trend in maternal health care utilization: antenatal care, delivery care, and postnatal care in Nepal. Maternal health remains a major challenge in developing countries despite improvements in medical technology and several efforts to improve maternal health care services. This study is based on Nepal Demographic and Health Survey data from 2006, 2011, and 2016. It covers 4,066 women in 2006, 4,148 in 2011 and 3,998 in 2016 for antenatal care. In the study, this analysis is confined to women aged (15-49) who had a live birth in the five years preceding the survey. Data on delivery care were obtained for all births that occurred in the five or two years preceding the survey. This study comprises 2030 women in 2011 and 1,978 women in 2016 aged 15–49 years who had a live birth in the two years preceding the survey on childbirth, and postnatal care. Especially, the study deals with antenatal, delivery care, and postnatal care. There is a substantial increase in the utilization of antenatal care (ANC) by skilled health providers from, 44 percent in 2006 to 84 percent in 2016 respectively. Still, six percent percentage do not seek even one-time ANC care and the percentage of women who seek 4 or more ANC care from a skilled service provider is low. Still, two fifth percent of delivery take place at home. postnatal service is still very low in Nepal. This study’s results suggest the need for efforts to be addressed to improve the use of maternal health care services in Nepal. There is a need to increase the use of postnatal checkup as well as delivery assisted by skilled attendants.
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Shah, Sunil. "Perceptions of users and providers on barriers to utilizing skilled birth care in Surkhet district of Nepal: a qualitative study." International Journal Of Community Medicine And Public Health 9, no. 3 (February 28, 2022): 1263. http://dx.doi.org/10.18203/2394-6040.ijcmph20220684.
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Background: Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care. Method: We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the perceptions and experiences of service users and providers regarding barriers to skilled birth care and explored possible solutions to overcoming such barriers.Results: Our results determined that major barriers to skilled birth care include inadequate knowledge of the importance of services offered by skilled birth attendants (SBAs), distance to health facilities, unavailability of transport services, and poor availability of SBAs. Other barriers included poor infrastructure, meager services, inadequate information about services/facilities, cultural practices and beliefs, and low prioritization of birth care. Moreover, the tradition of isolating women during and after childbirth decreased the likelihood that women would utilize delivery care services at health facilities.Conclusions: Service users and providers perceived inadequate availability and accessibility of skilled birth care in remote areas of Nepal, and overall utilization of these services was poor. Therefore, training and recruiting locally available health workers, helping community groups establish transport mechanisms, upgrading physical facilities and services at health institutions, and increasing community awareness of the importance of skilled birth care will help bridge these gaps.
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Pathak, Pratima, and Bijaya Ghimire. "Perception of Women regarding Respectful Maternity Care during Facility-Based Childbirth." Obstetrics and Gynecology International 2020 (July 4, 2020): 1–8. http://dx.doi.org/10.1155/2020/5142398.
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Background. Respectful care during childbirth has been described as “a universal human right that encompasses the principles of ethics and respect for women’s feelings, dignity, choices, and preferences.” Many women experience a lack of respectful and abusive care during childbirth across the globe. Objective. This study aimed to determine women’s perception of respectful maternity care (RMC) during facility-based childbirth. Method. A descriptive cross-sectional study was conducted among 150 mothers admitted to the maternity ward of Nepal Medical College and Teaching Hospital using a purposive sampling technique. Data were collected through an interview technique by using a validated tool containing 15 items each measured on a scale of 5. Statistical Package for Social Science (SPSS) version 16 was used for data analysis. Frequency, percentage, mean score, standard deviation, chi-square test, and binary logistic regression were used to analyze descriptive and inferential statistics. Results. In total, 84.7% of the women reported that they have experienced overall RMC services with a mean score ± SD (61.70 ± 12.12). Though the majority of the women reported that they have experienced RMC services, they also revealed that they have experienced disrespectful care in various forms such as being shouted upon (30.0%), being slapped (18.7%), delayed service provision (22.7%), and not talking positively about pain and relief during childbirth (28.0%). Likewise, length of stay, parity, and time of delivery were found as factors that influenced friendly care (COR = 0.383, 95% CI: 0.157–0.934), abuse-free care (COR = 3.663, 95% CI: 1.607–8.349), and timely care (COR = 2.050, 95% CI: 1.031–4.076) dimensions of RMC, respectively. Conclusion. Even though RMC emphasizes eliminating disrespectful and abusive environment from health facilities, 15.0% of participants perceived that they have not experienced overall RMC services. So, the health facility should focus on the interventions which ensure that every woman receives this basic human dignity during one of the most vulnerable times in their lives.
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Joshi, Supriya, and Yubraj Acharya. "Women’s extreme seclusion during menstruation and children’s health in Nepal." PLOS Global Public Health 2, no. 7 (July 20, 2022): e0000355. http://dx.doi.org/10.1371/journal.pgph.0000355.
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There is limited empirical evidence from low-income countries on the effects of women’s seclusion during menstruation on children’s health. The objective of the current study was to examine the association between women’s extreme seclusion during menstruation and their children’s nutritional status and health in Nepal. Using nationally representative data from the 2019 Multiple Indicator Cluster Survey, we examined the relationship between mother’s exposure to extreme forms of seclusion during menstruation and anthropometric measures of nutritional status and health outcomes among children ages 5–59 months (n = 6,301). We analyzed the data in a regression framework, controlling for potential confounders, including province fixed effects. We assessed extreme seclusion during menstruation based on women’s exposure to chhaupadi, a practice in which women are forced to stay away from home—in separate huts or animal sheds—during menstruation and childbirth. Mothers’ exposure to extreme seclusion during menstruation was associated with 0.18 standard deviation lower height-for-age z-scores (HAZ) (p = 0.046) and 0.20 standard deviation lower weight-for-age z-scores (WAZ) (p = 0.007) among children. Analysis by the place of seclusion showed that the negative association was stronger when women stayed in animal sheds—0.28 SD for HAZ (p = 0.007) and 0.32 SD for WAZ (p<0.001)—than when they stayed in separate huts. Extreme seclusion was associated with higher incidence of acute respiratory symptoms but not with incidence of diarrhea, irrespective of the place of seclusion. Women’s extreme seclusion during menstruation in Nepal has profound implications on the physical health of their children. Additional research is needed to ascertain potential mechanisms.
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Sangroula, Raj Kumar, Subash Khatiwada, Maginsh Dahal, Kushalata Baral, Bhuwan Thakurathi, Ramesh Barakoti, Menuka Sangroula, Sudip Khanal, Raj Kumar Subedi, and Raj Kumar Subedi. "Prevalence of Antenatal Care Practice among Marginalized Community of Nepal." Europasian Journal of Medical Sciences 2, no. 2 (December 30, 2020): 84–91. http://dx.doi.org/10.46405/ejms.v2i2.197.
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Background: The government of Nepal aims to improve the health of mothers and newborns by providing quality safe motherhood services. Increasing access and utilization of antenatal care (ANC) services are the first steps towards improving maternal and neonatal health outcomes, particularly those of the marginalized communities.Objective: The aim of this study is to assess the prevalence and factors associated with the antenatal care visits among the marginalized community of Nepal.Methods: A mixed-method study was conducted among 202 reproductive aged females of marginalized community in Nepal having childbirth during the last 2 years. Pre-tested semi-structured questionnaires and key informant interview guidelines were used for the collection of data. Bivariate and multiple regression analysis were carried out to find out the factors associated with the antenatal care visits. For qualitative data, thematic analysis was done. Results: More than half (56.9%) of the participants had completed four or more antenatal care visits. Mothers with primary level of education were 2.7 times more likely to complete four or more ANC visits (AOR: 2.7, CI: 1.09-7.07). Age at marriage (AOR: 2.3, CI: 1.08-5.22), women who took decisions alone for their health (AOR: 2.9, CI: 1.22-6.96),exposure to FCHV (AOR:2.5, CI: 1.1-5.9), knowledge about safe delivery incentive program (AOR: 3.6, CI: 1.46-9.0) and perception of “good quality” ANC service(AOR:7.5, CI: 3.3-17.1)were significantly associated with the number of ANC visits. Conclusion: The overall utilization of antenatal health services was low. So, there is a need of different community based maternal health programs especially targeting the marginalized females.
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Chaudhary, Rajendra Kumar, Krishna Bahadur Raut, and Kristina Pradhan. "Prevalence and Indications of Cesarean Section in a Community Hospital of Western Region of Nepal." Journal of Nepal Medical Association 56, no. 213 (October 31, 2018): 871–74. http://dx.doi.org/10.31729/jnma.3760.
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Introduction: Cesarean section is one of the common obstetric procedures done when the childbirth is not anticipated to occur by the normal vaginal delivery. There has been increased rate of cesarean section globally as well as in our country in recent decades.
Methods: This descriptive cross-sectional study has been carried out by reviewing a year of data from maternity ward of Paschimanchal Community Hospital, Prithvi Chowk, Pokhara. The total number of delivery, their modes either vaginal or cesarean, indications for the cesarean section and their outcomes were analyzed. The obtained data was entered and analyzed in Microsoft Excel.
Results: Total of 257 cases underwent delivery during the study period and 174 (63.27%) were by cesarean section. Oligohydramnios is the most common indication for cesarean section. Around 25 (14.36%) of the women underwent repeat cesarean section.
Conclusions: The rate of cesarean section was quite high in our study and further studies are recommended for understanding of causes and other associated factors with it.
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Kabra, Rita, Pooja Pradhan, Md Khurshid Alam Hyder, Taranath Pokhrel, Kabita Aryal, Anoma Jayathalika, Komal Preet Allagh, and James Kiarie. "Gaps and evidences on programming postpartum family planning services in Nepal." Gates Open Research 6 (August 2, 2022): 84. http://dx.doi.org/10.12688/gatesopenres.13606.1.
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Background: Postpartum family planning (PPFP) is one of the strategic efforts mentioned in the National Family Planning Strategy 2011/12 and National FP Costed implementation plan 2015-2020 of Nepal. Postpartum women are recognized as one of the groups that need attention to strengthen FP services in the country. Methods: We conducted a situational analysis in Nepal from December 2019 to May 2020, to identify the needs, gaps and provide evidence for strengthening future programming in this area using a combination of three methods: (i) non-systematic literature review using Google Scholar, Pubmed, and grey literature, (ii) secondary analysis using the dataset from Nepal Demographic and Health Survey (NDHS) 2016 that was based on a two-stage, stratified, nationally representative sample of households, and (iii) virtual assessment in purposively selected eight health facilities using a standard checklist related to PPFP. Results: Results show a lower modern contraceptive uptake (22.6%) and higher unmet need (31.5%) among postpartum women compared to all currently married women (43% and 24% respectively). Three most commonly used modern contraceptive methods among postpartum women in Nepal are injectables (8%), male condoms (7%), and oral contraceptive pills (3%). The PPFP services are available only in limited health facilities and were not integrated in Antenatal care (ANC), Postnatal care (PNC), childbirth and immunization services. Provision of family planning counseling during the ANC period is not recorded in the ANC card. Male partners do not participate in family planning counseling. Similarly, the uptake of family planning services at immunization, child health, and postnatal clinics is not recorded. Conclusion: This analysis provided evidence of the current status of PPFP in the country. There are gaps and challenges especially in strategy and guidelines, training, regular supply of commodities, awareness of PPFP, recording and reporting of PPFP. These gaps should be addressed with appropriate strategies.
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Shrestha, Bidhya. "Does women empowerment affect in Timing of Antenatal Care Initiation in Nepal?" Nepal Journal of Multidisciplinary Research 5, no. 5 (December 31, 2022): 86–95. http://dx.doi.org/10.3126/njmr.v5i5.51807.
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Background: Many pregnant women who are in their first trimester of pregnancy are still being left behind and do not attend antenatal care (ANC) visits on time, which is unfortunately a dreadful condition. This paper explores the dimensions of women empowerment and their relationship to the timely initiation of ANC.
Methods: The study is based on the 2016 Nepal Demographic and Health Survey. Currently married women aged 15-49 years (n=1,973) who had live births 2 years before the survey were the main target population. The study used binary logistic regression to examine the causal relationship between women empowerment and the timing of ANC service.
Results: The findings reveal that more than two-thirds of the respondents who had a live birth two years prior to the survey made their first antenatal visit during the first trimester. Eight out of 10 highly empowered women are more likely to visit in the first trimester than low empowered women. Furthermore, according to the study, the level of women empowerment affects the timing of ANC service. Furthermore, except for control over sexual relations, indicators-wise empowerment level indicates a positive impact on the timing of ANC services.
Conclusions: Women, especially young women, should be empowered in order to meet the SDG target. There should not be any maternal deaths during pregnancy as well as childbirth and after birth.
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Karkee, Rajendra, Andy H. Lee, and Colin W. Binns. "Bypassing birth centres for childbirth: an analysis of data from a community-based prospective cohort study in Nepal." Health Policy and Planning 30, no. 1 (November 21, 2013): 1–7. http://dx.doi.org/10.1093/heapol/czt090.
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Chhetri, Sita, Rajani Shah, and Laxmi Rajbanshi. "Factors Associated with Utilization of Complete Postnatal Care Service in Baglung Municipality, Nepal." International Journal of Reproductive Medicine 2020 (July 20, 2020): 1–8. http://dx.doi.org/10.1155/2020/2892751.
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Background. Postnatal period is six weeks after birth. It is critical but is the most neglected period. A large proportion of maternal and neonatal deaths occur during 48 hours following childbirth. The utilization of the recommended three postnatal checkups within seven days after delivery, which plays a vital role in preventing maternal and neonatal deaths, is low in Nepal. Objective. This study is aimed at identifying the factors associated with the utilization of complete postnatal care (PNC) among mothers. Method. A cross-sectional study was carried out among 318 mothers in wards 1, 2, 3, and 4 of Baglung municipality, Nepal. Data was collected by semi-structured interviews. Descriptive analysis and comparison of characteristics of women/families with complete vs. partial postnatal checkups using multivariable logistic regression were done. Results. Among 314 respondents receiving at least one PNC, 78% had partial and 22% had complete PNC. Relatively advantaged caste/ethnicity- Brahman/Chhetri (aOR=3.18, 95% CI: 1.24-8.12) and Janajati (aOR=2.87, 95% CI: 1.09-7.53) - compared to Dalits, husbands working as a job holder in Nepal (aOR=3.49, 95% CI: 1.50-8.13), and delivery in a private hospital (aOR=11.4, 95% CI: 5.40-24.2) were associated with having complete PNC. Conclusion. Although PNC attendance at least once was high, utilization of complete PNC was low. More focus to mothers from disadvantaged caste/ethnicity, those whose husbands are in foreign employment, and improvement in quality of care in government health facilities may increase the use of complete PNC.
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Karki, Rita Devi. "Factors Associated with Safe Motherhood Practices among Young Married Women." Tribhuvan University Journal 36, no. 01 (December 31, 2021): 58–72. http://dx.doi.org/10.3126/tuj.v36i01.43579.
Full textAbstract:
Safe motherhood is one of the key components of reproductive health and young women are notably concerned with the population of it in Nepal. This study attempts to analyze the factors associated with safe motherhood practices among young married women in five child marriage prevalence districts identified by UNFPA. The analysis uses data from research entitled “Situation Assessment of Child Marriage in Selected Five Intervention Districts of Nepal” conducted in 2017.It was confined to the women (N=239) who had at least one child. Bivariate analysis is used to identify the level of association between background characteristics and safe motherhood practices. The result showed nearly four in five (77.8%) women were married age at 15-19 years and more than three-fifth (61.1%) started to give birth. Regarding education, only 18 percent received the degree of SLC and above. Women who were engaged in marriage at below 15 have significantly fewer visits to the ANC in comparison to the women married at age 20-24 years. Women who have two or more children were significantly less likely to visit health institutions for delivery and PNC. The result indicates that adolescents face a high risk of complications during pregnancy and childbirth due to biological immaturity and socio-economic factors.
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Chalise, Anisha, and Tulsi Ram Bhandari. "Postpartum Depression and its Associated Factors: A Community-based Study in Nepal." Journal of Nepal Health Research Council 17, no. 2 (August 4, 2019): 200–205. http://dx.doi.org/10.33314/jnhrc.v0i0.1635.
Full textAbstract:
Background: Postpartum depression is a type of mental disorder associated with childbirth during pregnancy or within the first postpartum year. It is reported as a common psychological health problem affecting 10-15% of women worldwide. The duration of postpartum depression frequently depends on its severity and the time of initiation of treatment. This study assessed depression and its associated factors among postpartum period women of Godavari municipality, Lalitpur, Nepal.Methods: A community-based cross-sectional study was conducted using Edinburg Postpartum Depression Scale among 195 mothers who were within six months of the postpartum period. The chi-square and logistic regression were applied to establish the association between postpartum depression and associated factors. Results: Out of the total 195 postpartum women, 37(19%) women suffered from depression and out of those women 2.1% had suicidal thoughts. Among the associated factors, education, occupation, the intent of pregnancy, family support and pregnancy-related problems/complications were found to be significantly associated with Postpartum depression (p<0.05). Conclusions: Nearly one-fifth postpartum women suffered from some type of depression. It is one of the public health concerns which directly or indirectly corresponds to the socio-economic condition of the women. The improved education and economic status of women, intention of pregnancy, family care and support during pregnancy and the postpartum period and early diagnosis and management of health problems could reduce the magnitude of the postpartum depression. Keywords: Associated factors of postpartum depression; edinburg postpartum depression scale; Nepal; postpartum depression.
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Sanjel, S., R. H. Ghimire, and K. Pun. "Antenatal Care Practices in Tamang Community of Hilly Area in Central Nepal." Kathmandu University Medical Journal 9, no. 2 (June 10, 2012): 57–61. http://dx.doi.org/10.3126/kumj.v9i2.6290.
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Background Antenatal care is provided during pregnancy to save lives of mother and foetus. World Health Organization recommends four focused visits as sufficient for normal pregnancy. Objective The objective of the study was to find out antenatal care practices in Tamang community of hilly areas of central Nepal. Methods Descriptive cross-sectional study was conducted in Tamang community of Lalitpur district. Systematic random sampling method was used to collect data from April to May 2011. Data of 194 women having ?3 years of children was collected and analyzed in descriptive and inferential ways. Results Antenatal visits were made by 78.9% (153) of women but only 46.4% (71) completed four antenatal visits. Mean visit was of 3.5 ± 1.13 times. Ninety four (61.4%) of first antenatal visits attainders completed the fourth visit. Age of women and antenatal visits, taking tetanus toxoid injection and knowledge on work of iron tablets exhibited significant association at 95% level of confidence (p <0.05). There was also significant association between numbers of childbirth and antenatal visits at 95% level of confidence (p <0.05). ConclusionsThere was a high rate of early marriage and early pregnancy in the Tamang communities. Women did not place high importance on antenatal visits. A large percentage did not complete all four recommended antenatal visits. Use of necessary medicine like iron, albendazole tablets and tetanus toxoid injection was often incomplete. DOI: http://dx.doi.org/10.3126/kumj.v9i2.6290 Kathmandu Univ Med J 2011;9(2):57-61
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Gana, G. "Post Partum Care Practices among Postnatal Mothers in Tharu Community, Kailali District, Nepal." Journal of Chitwan Medical College 3, no. 2 (August 13, 2013): 24–26. http://dx.doi.org/10.3126/jcmc.v3i2.8438.
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Postnatal mothers are in high risk because most of the deaths occur in this period as compared to pregnancy and childbirth. The objectives of the research was to assess & find out the factors associated with post partum care practices among postnatal mothers and to suggest the measures for the utilization of post partum care services. A total of 175 respondents (all mothers having children below one year) were selected by using multi stage sampling technique from different wards of Dhangadi municipality, and Beladevipur, Geta, Phulbari, & Sripur VDCs of Kailali district from January to June, 2009. The data were statistically analyzed by using chi square test & Pearsons’ correlation test. Family income plays a significant role in Nutritious diet within 24 hours. Occupation had no effect on the frequency of postnatal visits. Education plays a significant role in changing perineal pad. Only 49.7% of respondents had done postnatal visit. Education plays significant role on colostrum feeding practices. Odds ratio = 4.09 (CI=32.06-55.34) at 95% confidence limit. Literate respondents have 4 times more practice of colostrum feeding as compared to illiterate. Distance plays a significant role in health facilities. Education of mothers play major role in postpartum care practices. DOI: http://dx.doi.org/10.3126/jcmc.v3i2.8438 Journal of Chitwan Medical College Vol.3(2) 2013 24-26