Experts warn that Nepal is not on track to meet SDG maternal health targets

ByLaxman Datt Pant

Experts warn that Nepal is not on track to meet SDG maternal health targets

Despite a gradual improvement in women’s sexual and reproductive health, Nepal is likely to fail in its commitment to meet the UN Sustainable Development Goal (SDG) indicator 3.1 to reduce maternal mortality to less than 70 per 100,000 live births by 2030. Furthermore, the country’s target to reduce maternal mortality to 125 per 100,000 births by 2020 has also become unachievable due to the increased number of maternal deaths since the COVID-19 related lockdown was imposed on March 24. The country’s current maternal mortality rate is 239 per 100,000, the second-highest maternal death level in South Asia.

A total of 43 women have died of pregnancy-related complications in the last three months according to Dr. Bhim Singh Tinkari, Director at the Family Welfare Division of the Department of Health Services. Reflecting on this upsetting fact Dr. Laxmi Tamang, President of the Midwifery Society of Nepal (MIDSON) said:

 “Had the government established a well-functioning national healthcare delivery system beforehand, these deaths could have been prevented.”

Tamang added that to achieve the SDG by 2030, a 12% annual reduction would be required to reduce maternal mortality rate by 71% during the next decade. She added that this mission was almost impossible.

Bandana Rana, Vice-Chair of the United Nations’ Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) Committee, sees the situation as very worrying stating that pregnant women and their families are failing to attend hospitals for fear of corona transmission.

The government is unable to assure adequate medical safety to pregnant women and lacks vision for introducing a practical capacity building plan to safeguard women’s sexual and reproductive health and rights, Rana added.

It is to be noted that the CEDAW Committee introduced a nine-point guidance note to provide gender-responsive sexual and reproductive health services, including maternity care, as part of their COVID-19 response.

It states, “Confidential access to sexual and reproductive health information and services such as modern forms of contraception, safe abortion and post-abortion services and full consent must be ensured to women and girls at all times, through toll-free hotlines and easy-to-access procedures such as online prescriptions, if necessary free of charge.

Dr. Usha Jha, a Member of the National Planning Commission (NPC) is of the opinion that an alternative plan for pregnant women needs to be introduced to minimize the impact of COVID19. Although Nepal demonstrated an excellent trend between 1990 to 2019, decreasing the maternal death rate from 850 per 100,000 live births to 239 in 2018/2019, this progress has already slowed down as there has been little antenatal and postnatal care available at health facilities and birthing centers, Jha added.

Meanwhile, Dr. Sangita Mishra, Director of Paropakar Maternity and Women’s Hospital (PMWH) – Nepal’s first maternity hospital responded that the number of those seeking maternity services has decreased due to the lockdown.

“The number of women seeking daily delivery service at the hospital is just 40 which is 50% less than that in a normal period”, Mishra advised.

The Maternal and Perinatal Death Surveillance Response (2015-2017) of Nepal shows that more than 75% of mothers died from preventable pregnancy and childbirth-related direct causes such as bleeding, hypertensive disorders, infections, abortion, and other obstetric complications. Of these, 48% died within 40 hours after childbirth and whilst in a health facility setting.

“It is high time that Nepal adopted evidence-based policies by developing and deploying skilled midwifery professionals to ensure easy access to health services for pregnant women”, Dr. Tamang recommended.

Nepal Family Planning Project (NFPP) is currently being implemented with support from the United Kingdom’s Department for International Development (DFID) and the United Nations Population Fund (UNFPA). The project aims to safeguard family planning services for women who are poor and socially excluded in remote districts of Nepal. Additionally, UNFPA is supporting in identifying statistical data gaps and monitoring progress towards the SDGs.

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