Maternal and newborn health survey of two rural districts in Nepal quantifies hurdles in fulfilling Millennium Development Goals 4 and 5

A 2009 study of mothers to children age 0-23 and recently delivered women (n=900; 1200, respectively) in two districts of Nepal demonstrated significant gaps in access to critical maternal and newborn health services. Proportions of women who sought and obtained antenatal care, normal delivery, and postnatal care were below levels necessary to achieve the United Nation's Millennium Development Goal's skilled-care coverage and availability aims. The study included a household survey using probability proportions to size cluster sampling of mothers of children 0-23 months and recently delivered women. Data indicate that only 23% and 26% (95%CI [20.78, 25.56], [23.01, 28.73]) of deliveries are attended by a skilled provider across districts, while the proportion of mothers making four or more ANC visits were 37% and 47% (95% CI [34.04, 40.36], [44.25, 49.89]), respectively. The proportion of mothers who received a post-partum visit from a trained health worker within two days of birth were 39% and 44% (95% CI [36.14, 41.66], [41.11, 47.61]). Further analyses of newborn health indicate that only 5% and 17% (95% CI [2.28, 7.06], [13.69, 19.65]) of children received all elements of essential newborn care including immediate thermal protection, clean cord care, and immediate/exclusive breastfeeding. Results indicate a need to increase and sustain the utilization, availability, and quality of community and facility-based maternal and newborn care services in Nepal. Promoting the use of antenatal care, skilled birth attendance, postnatal care and newborn health services remain vital to regional success in fulfilling Millennium Development Goals 4 and 5.