In Nepal, the utilization of maternal, newborn and child health (MNCH)
Key Words:Disadvantaged community, inequality health care service, maternal and newborn mortality, pregnant women's group, utilization of health care service ISSN: 2362-1303 (Paper) | eISSN: 2362-1311(Online)
JOURNAL OF ADVANCED ACADEMIC RESEARCH (JAAR)Jan 2016 A Pregnant Women's Group: Page24 Vol. 3. No. I www.phdcentre.edu.np
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INTRODUCTIONThe maternal mortality ratio (MMR) in developing regions is still considerably high and stands at 239 per 100,000 live births as of 2015, which is roughly 20 times higher than that of developed regions. Regions such as Oceania, South Asia and South Eastern Asia have average MMR of 187, 176 and 110 respectively. Nepal which lies in the South Asia has MMR of 258 per 100,000 live births (WHO, 2015).Further still under-five mortality rate (U5MR) in South Asian region is high and stands at 51 deaths per 1,000 live births as of 2015. This implies that three in 10 global under-five deaths occur in Southern Asia. Nepal has U5MR of 36 and neonatal mortality rate of 22 deaths per 1,000 live births as of 2015 (UNICEF 2015). The child deaths are caused by diseases that are readily preventable or treatable with proven, cost-effective and quality-delivered interventions. The interventions include active management of third stage of labour, use of misoprostol, community based newborn care programme, naval care with chlorhexidine. The Government of Nepal is implementing these interventions free of cost at all government health facilities. However, despite the availability of the services, the rate of access and utilization of the services especially among the needy and vulnerable is very low partly because the communities still think such services are not important. Then there is a challenge of how to make those services accessible and utilizable by the needy people and of how to reduce on the maternal and newborn deaths. Studies have shown that there is a big gap in the utilization of health care services between rich and poor, literate and illiterate in Nepal despite those services being free of cost. For example: studies showed that the poorest quintile had a 10.7% SBA delivery rate; whereas the wealthiest quintile had a rate of 81.5%, despite SBA services being free of cost at government health facilities (Ministry of Health and Population Nepal, New Era, and ICF International INC. 2012). There is a need of innovative processes and strategies to increase the utilization of locally available maternal and newborn health services. As such the government of Nepal initiated, the pregnant women group (PWG) approach to increase the utilization of health care services especially among disadvantaged communities in six districts of Nepal, namely Sunsari, Rautahat, Bara, Parsa, Makawanpur and Banke. As a result more than 1,200 PWGs have been established from 2003 to 2013. Therefore my research focused on PWG approach and how it increases the utilization of maternal and newborn health services by mostly needy commu...