Antenatal to Postnatal: Assessing the Continuum of Maternal Health Service Utilization in Palpa, Nepal.
Abstract
Introduction: One of the most prioritized programs of Government of Nepal is maternal health. Optimum utilization of maternal health services during pregnancy, delivery and post-natal period is an effective approache to reduce the maternal morbidity and mortality that helps us achieve the sustainable development goals target. This study aimed to assess the utilization of maternal health services including antenatal, intranatal and postnatal services among women in the Palpa district of Nepal. Methods: A descriptive cross-sectional study was conducted among 168 mothers in their reproductive age using a convenient sampling method. The study included those mothers who had a delivered a child in the past two years, in Palpa district. The data collection commenced from March to September 2023. The data analysis was conducted using Statistical Package for Social Sciences software (v 21.0). Results: A remarkable finding in the present study was 88.1% of mothers had utilized a minimum of four antenatal check-ups, as recommended by the Government of Nepal. Out of 168 mothers included in the present study 89.9% had institutional delivery while the remainder had home delivery. Post-natal check-ups following delivery was surprisingly uncommon as it was observed that only 28% mothers sought such care. Adequate utilization of maternal health services is influenced by factors such as proximity of health facilities, education level, and knowledge of maternal incentives. Conclusion: While service utilization for pregnancy and delivery in Palpa district aligns with national standard, further research is needed to identify factors contributing to underutilization of postnatal services.
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References
Ministry of Health and Population, Nepal. Safe Motherhood Programme [Internet]. Kathmandu, Nepal: Ministry of Health and Population; 2022 [cited 2024 Jan 17]. Available from: https://mohp.gov.np/program/safe-motherhood-programme/en
World Health Organization. Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division: executive summary [Internet]. Geneva: WHO; 2023 [Cited 2024 Jan18]. Available from: https://www.who.int/publications/i/item/9789240069251
Musarandega R, Nyakura M, Machekano R, Pattinson R, Munjanja SP. Causes of maternal mortality in Sub-Saharan Africa: A systematic review of studies published from 2015 to 2020. J Glob Health. 2021;11(0):04048. PMID: 34737857 DOI: https://doi.org/10.7189/jogh.11.04048
UNICEF DATA. Antenatal care [Internet]. New York: UNICEF; 2024 [cited 2024 Jan 17]. Available from: https://data.unicef.org/topic/maternal-health/antenatal-care/
UNFPA Nepal. Right to Safe Motherhood and Reproductive Health Act 2075 [Internet]. Nepal: UNFPA; 2019 [cited 2024 Jan 17]. Available from: https://nepal.unfpa.org/en/publications/right-safe-motherhood-and-reproductive-health-act-2075
Ministry of Health and Population, New Era, The DHS Program. Nepal Demographic and Health Survey 2022 [Internet]. Nepal: Ministry of Health and Population; 2022. Available from: https://mohp.gov.np/uploads/Resources/Nepal%20Demographic%20and%20Health%20Survey%202022%20Key%20Indicators%20Report.pdf
Bhattarai P. Factors Associated with Use of Maternal Health Services in Nepal: Analysis of the 2016 Nepal Demographic and Health Survey. Journal of Nepal Health Research Council. 2019;17(3):301-7. DOI: https://doi.org/10.33314/jnhrc.v17i3.1525
Tafere TE, Afework MF, Yalew AW. Antenatal care service quality increases the odds of utilizing institutional delivery in Bahir Dar city administration, North Western Ethiopia: A prospective follow up study. PLOS ONE. 2018;13(2):e0192428. PMID: 29420598 DOI: https://doi.org/10.1371/journal.pone.0192428
Agha S, Williams E. Quality of antenatal care and household wealth as determinants of institutional delivery in Pakistan: Results of a cross-sectional household survey. Reprod Health. 2016;13(1):84. PMID: 27430518 DOI: https://doi.org/10.1186/s12978-016-0201-5
Banke-Thomas OE, Banke-Thomas AO, Ameh CA. Factors influencing utilisation of maternal health services by adolescent mothers in Low-and middle-income countries: a systematic review. BMC Pregnancy and Childbirth. 2017;17(0):65. DOI: https://doi.org/10.1186/s12884-017-1246-3
Nepal Health Sector Support Programme. Distance to a health facilities as a factor in the uptake of institutional delivery in Nepal [Internet]. Nepal: Nepal Health Sector Support Programme [cited 2024 Jan 16]. Available from: https://www.nhssp.org.np/Resources/EA/Distance%20to%20a%20health%20facility%20as%20a%20factor%20in%20the%20uptake%20of%20instituional%20delivery%20in%20Nepal.pdf
Adhikari M, Chalise B, Bista B, Pandey AR, Upadhyaya DP. Sociodemographic correlates of antenatal care visits in Nepal: results from Nepal Demographic and Health Survey 2016. BMC Pregnancy Childbirth. 2020;20(0):513. DOI: https://doi.org/10.1186/s12884-020-03218-x
Mamuye Azanaw M, Gebremariam AD, Teshome Dagnaw F, Yisak H, Atikilt G, Minuye B, et al. Factors Associated with Numbers of Antenatal Care Visits in Rural Ethiopia. J Multidiscip Healthc. 2021;14:1403-11. PMID: 34140778 DOI: https://doi.org/10.2147/jmdh.s308802
Nababan HY, Hasan M, Marthias T, Dhital R, Rahman A, Anwar I. Trends and inequities in use of maternal health care services in Indonesia, 1986-2012. Int J Womens Health. 2017;10(0):11-24. PMID: 29343991 DOI: https://doi.org/10.2147/ijwh.s144828
Subedi S, Kaphle HP, Acharya S, Gupta N, Jain V. Maternal incentive scheme in Nepal – status of knowledge and financial benefits received by mothers on ANC incentive and safe delivery incentive program. Indian Journal of Community Health. 2014;26(3):273-7. Available from: https://www.iapsmupuk.org/journal/index.php/IJCH/article/view/421
Bhaskar RK, Deo KK. Determinants of Utilization of Institutional Delivery Services in East Nepal: A Community-Based Cross- Sectional Study. Med Phoenix. 2018;3(1):6-15. DOI: https://doi.org/10.3126/medphoenix.v3i1.20755
Department of Health Services. Annual Report Department of Health Services 2073/74(2016/2017) [Internet]. Kathmandu, Nepal: Government of Nepal, Ministry of Health and Population, Department of Health Services; 2018 [cited 2024 Jan 26]. Available from: http://dohs.gov.np/wp-content/uploads/2018/04/Annual_Report_2073-74.pdf
Shrestha N, Tiwari B, Piryani S, Khanal G. Postnatal care services utilization in Bharatpur metropolitan city, Chitwan, Nepal. Journal of Chitwan Medical College. 2019;9(29):43-50. Available from: https://www.nepjol.info/index.php/JCMC/article/view/25781

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