Learning from Nepal’s Progress to Inform the Path to the Sustainable Development Goals for Health, Leaving No-One Behind

Lawn, Joy E; Ashish, K C

doi:10.1007/s10995-020-02899-2

Cited by 5 publications

(5 citation statements)

References 14 publications

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“…However, in 2016 the neonatal mortality rate declined rapidly to 21 per 1000 live births [6]. Owing to these achievements, Nepal was one of the exemplary countries to meet Millennium Development Goals (MDGs) related to child survival (MDG-4), and maternal health (MDG-5), and its success stories have been globally commended [7].…”

Section: Introductionmentioning

confidence: 99%

Basic emergency obstetric and newborn care service availability and readiness in Nepal: Analysis of the 2015 Nepal Health Facility Survey

Acharya¹,

Subedi²,

Dahal

et al. 2021

PLoS ONE

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Background Achieving maternal and newborn related Sustainable Development Goals targets is challenging for Nepal, mainly due to poor quality of maternity services. In this context, we aim to assess the Basic Emergency Obstetric and Newborn Care (BEmONC) service availability and readiness in health facilities in Nepal by analyzing data from Nepal Health Facility Survey (NHFS), 2015. Methods We utilized cross-sectional data from the nationally representative NHFS, 2015. Service availability was measured by seven signal functions of BEmONC, and service readiness by the availability and functioning of supportive items categorized into three domains: staff and guidelines, diagnostic equipment, and basic medicine and commodities. We used the World Health Organization’s service availability and readiness indicators to estimate the readiness scores. We performed a multiple linear regression to identify important factors in the readiness of the health facilities to provide BEmONC services. Results The BEmONC service readiness score was significantly higher in public hospitals compared with private hospitals and peripheral public health facilities. Significant factors associated with service readiness score were the facility type (14.69 points higher in public hospitals, P<0.001), number of service delivery staff (2.49 points increase per each additional delivery staff, P<0.001), the service hours (4.89 points higher in facilities offering 24-hour services, P = 0.01) and status of periodic review of maternal and newborn deaths (4.88 points higher in facilities that conducted periodic review, P = 0.043). Conclusions These findings suggest that BEmONC services in Nepal could be improved by increasing the number of service delivery staff, expanding service hours to 24-hours a day, and conducting periodic review of maternal and newborn deaths at health facilities, mainly in the peripheral public health facilities. The private hospitals need to be encouraged for BEmONC service readiness.

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Section: Introductionmentioning

confidence: 99%

Basic emergency obstetric and newborn care service availability and readiness in Nepal: Analysis of the 2015 Nepal Health Facility Survey

Acharya¹,

Subedi²,

Dahal

et al. 2021

PLoS ONE

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“… 9 – 11 Patients living in remote geographic locations or experiencing lack of transportation, childcare, or job security face significant barriers to attending in-person visits, affecting their ability to access necessary care. 12 Care experience and quality can also be influenced by stressful or discriminatory encounters within the health care environment, inability of support people to join appointments, and limited options for health care practitoners. 13 , 14 Telemedicine presents a promising opportunity to address these social determinants of health and their resulting inequities.…”

mentioning

confidence: 99%

Ensuring Equitable Implementation of Telemedicine in Perinatal Care

Ukoha¹,

Davis²,

Yinger³

et al. 2021

Obstetrics &Amp; Gynecology

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“…Food insecurity can compromise maternal nutrition and increase risk of LBW births, particularly among WLHIV [50]. Poverty, low quality health care, and neighborhood deprivation are major structural causes of deaths among LBW neonates in Ghana [5,28,51,52]. The reluctance to visit a LBW baby may also be linked to their high mortality rate, and visitors fear of been blamed for their deaths, which is consistent with local beliefs of illness and causes of newborn deaths [53,54].…”

Section: Discussionmentioning

confidence: 88%

“…To tackle the adverse effects of stigma, Parker encourages attention to the structural factors that produce stigmatization [24]. In Ghana, LBW disproportionately affects women who are poor, young, unmarried, infected with HIV, have poor nutritional status, and have inadequate access to healthcare [17,[25][26][27][28]. These risk factors are shaped by the political economy and women's position in society.…”

Section: Introductionmentioning

confidence: 99%

Stigma toward small babies and their mothers in Ghana: A study of the experiences of postpartum women living with HIV

et al. 2020

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Infants born to HIV-infected mothers are more likely to be low birthweight (LBW) than other infants, a condition that is stigmatized in many settings worldwide, including sub-Saharan Africa. Few studies have characterized the social-cultural context and response to LBW stigma among mothers in sub-Saharan Africa or explored the views of women living with HIV (WLHIV) on the causes of LBW. We purposively sampled thirty postpartum WLHIV, who had given birth to either LBW or normal birthweight infants, from two tertiary hospitals in Accra, Ghana. Using semi-structured interviews, we explored women's understanding of the etiology of LBW, and their experiences of caring for a LBW infant. Interviews were analyzed using interpretive phenomenology. Mothers assessed their babies' smallness based on the baby's size, not hospital-recorded birthweight. Several participants explained that severe depression and a loss of appetite, linked to stigma following an HIV diagnosis during pregnancy, contributed to infants being born LBW. Women with small babies also experienced stigma due to the newborns' "undesirable" physical features and other people's unfamiliarity with their size. Consequently, mothers experienced blame, reluctance showing the baby to others, and social gossip. As a result of this stigma, women reported self-isolation and depressive symptoms. These experiences were layered on the burden of healthcare and infant feeding costs for LBW infants. LBW stigma appeared to attenuate with increased infant weight gain. A few of the women also did not breastfeed because they thought their baby's small size indicated pediatric HIV infection. Among WLHIV in urban areas in Ghana, mother and LBW infants may experience LBW-related stigma. A multi-component intervention that includes reducing LBW incidence, treating antenatal depression, providing psychosocial support after a LBW birth, and increasing LBW infants' weight gain are critically needed.

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Learning from Nepal’s Progress to Inform the Path to the Sustainable Development Goals for Health, Leaving No-One Behind

Cited by 5 publications

References 14 publications

Basic emergency obstetric and newborn care service availability and readiness in Nepal: Analysis of the 2015 Nepal Health Facility Survey

Basic emergency obstetric and newborn care service availability and readiness in Nepal: Analysis of the 2015 Nepal Health Facility Survey

Ensuring Equitable Implementation of Telemedicine in Perinatal Care

Stigma toward small babies and their mothers in Ghana: A study of the experiences of postpartum women living with HIV

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