The recently completed Maternal Mortality and Morbidity Study, carried out in eight districts of Nepal, as a follow on to a similar study in 1997, provides new insights into the effects of community and facility related factors on maternal outcomes. The main study findings were disseminated at a meeting of stakeholders in November 2009.
An encouraging finding was the maternal mortality ratio for the eight study districts of 229 per 100,000 live births, a figure that is consistent with the 2006 Demographic and Health Survey national result of 281, a dramatic drop from the 1997 figure of 539. The results of verbal autopsies and interviews carried out in communities and health facilities show that many of the women who died as a result of pregnancy and delivery complications went to a facility too late, when their condition was already critical; or went to an inappropriate facility first, thus wasting time before accessing the level of care they needed; and/or experienced delays or poor service at the facility due to lack of appropriately skilled staff, equipment or supplies. The mountain districts surveyed do not have comprehensive emergency care services, meaning that women in these districts have to travel further for care, and the facilities are generally less well equipped and staffed than those in the Tarai.
An important finding was that maternal/ pregnancy related causes were no longer the leading cause of death for women of reproductive age, but now ranked third, reflecting improvements in management of pregnancy complications over the last decade. In particular the contribution of postpartum haemorrhage to maternal deaths has been reduced (from 41% to 24%), although it remains the leading cause. The contributions of eclampsia and abortion have increased. A shocking finding was that suicide was the leading single cause of death (16%), where it was only ranked third in 1997. Please click 'Research' under Resources Section; or simply follow the below link for full report.
