Inequalities in the Use of Family Planning in Rural Nepal

Mehata, Suresh; Paudel, Yuba Raj; Dotel, Bhogendra Raj; Singh, Dipendra Raman; Poudel, Pradeep; Barnett, Sarah A.

doi:10.1155/2014/636439

Cited by 21 publications

(32 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For family planning, a decade of slow progress in terms of intensification of modern method contraceptive use to prevent unwanted pregnancies is noted (Mehata et al 2014;Shrestha et al 2012). Nepal revitalised its commitment for family planning programming through the development and implementation of Nepal National Family Planning Costed Implementation Plan 2015-2020 (Ministry of Health and Population Nepal 2015).…”

Section: Number Of Deathsmentioning

confidence: 99%

Equity and Coverage in the Continuum of Reproductive, Maternal, Newborn and Child Health Services in Nepal-Projecting the Estimates on Death Averted Using the LiST Tool

Thapa

Budhathoki

Gurung

et al. 2019

Matern Child Health J

View full text Add to dashboard Cite

Introduction The third Sustainable Development Goal, focused on health, includes two targets related to the reduction in maternal, newborn and under-five childhood mortality. We found it imperative to examine the equity and coverage of reproductive, maternal, newborn and child health (RMNCH) interventions from 2001 to 2016 in Nepal; and the death aversion that will take place during the SDG period. Methods We used the datasets from the Nepal Demographic Health Surveys (NDHS) 2001(NDHS) , 2006(NDHS) , 2011(NDHS) and 2016. We calculated the coverage and equity for RMNCH interventions and the composite coverage index (CCI). Based on the Annualized Rate of Change (ARC) in the coverage for selected RMNCH indicators, we projected the trend for the RMNCH interventions by 2030. We used the Lives Saved Tools (LiST) tool to estimate the maternal, newborn, under-five childhood deaths and stillbirths averted. We categorised the interventions into four different patterns based on coverage and inequity gap. Results Between 2001 and 2016, a significant improvement is seen in the overall RMNCH intervention coverage-CCI increasing from 46 to 75%. The ARC was highest for skilled attendance at birth (11.7%) followed by care seeking for pneumonia (8.2%) between the same period. In 2016, the highest inequity existed for utilization of the skilled birth attendance services (51%), followed by antenatal care (18%). The inequity gap for basic immunization services reduced significantly from 27.4% in 2001 to 5% in 2016. If the current ARC continues, then an additional 3783 maternal deaths, 36,443 neonatal deaths, 66,883 under-five childhood deaths and 24,024 stillbirths is expected to be averted by the year 2030. Conclusion Nepal has experienced an improvement in the coverage and equity in RMNCH interventions. Reducing inequities will improve coverage for skilled birth attendants and antenatal care. The current annual rate of change in RMNCH coverage will further reduce the maternal, neonatal, under-five childhood deaths and stillbirths.

show abstract

Section: Number Of Deathsmentioning

confidence: 99%

Equity and Coverage in the Continuum of Reproductive, Maternal, Newborn and Child Health Services in Nepal-Projecting the Estimates on Death Averted Using the LiST Tool

Thapa

Budhathoki

Gurung

et al. 2019

Matern Child Health J

View full text Add to dashboard Cite

show abstract

“…Previous studies exploring inequalities in health outcomes and utilization in Nepal have found that inequalities exist by urban/rural place of residence, ecological region, and distance to health facility. [13][14][15][16][17][18] However, it is less clear whether these inequalities are driven by supply side factors such as service readiness. The objective of this study was to assess extent of service readiness by geography, province and key management practices in primary health care centers and hospitals of Nepal.…”

Section: Conclusion Conclusionmentioning

confidence: 99%

General health service readiness and its association with the facility level indicators among primary health care centers and hospitals in Nepal

Acharya¹,

Paudel

2019

Journal of Global Health Reports

View full text Add to dashboard Cite

Background Background Health care quality has gained unprecedented attention within health systems. In line with the commitments of Government of Nepal's (GoN) 2014 Health Policy and 2015 Constitution of Nepal, GoN is striving to achieve the goal of leaving no one behind with the provision of quality health services. This study aimed to assess health service readiness in hospitals and primary health care centers (PHCCs) of Nepal. Methods Methods This analysis used data from the 2015 Nepal Health Facility Survey (NHFS), a nationally representative health facility survey that provide information on formal sector health facilities. The data for the analysis for this study was collected using the Inventory Questionnaire collected information on staffing, staff training, infrastructure, medicines, supplies, and services offered in health facilities assessed their service readiness within acceptable standards. The WHO Service Availability and Readiness Assessment (SARA) manual was used to guide the selection of indicators to measure general service readiness. Linear regression analysis was conducted to find the relationship between the facility readiness and the covariates, ie, facility level indicators. Acharya K, Paudel YR. General health service readiness and its association with the facility level indicators among primary health care centers and hospitals in Nepal.

show abstract

“…Low use of maternal health services has been observed among Dalits (the castes who were formerly considered “untouchable” according to the Hindu varna system), Muslims, and Terai/Madhesi (the Terai/Madhesi people are native inhabitants of the flat southern region of Nepal) peoples. The use of maternal health care has been found to be low among those who reside in rural areas and the poor [ 10 , 11 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Trends and Inequalities in Use of Maternal Health Care Services in Nepal: Strategy in the Search for Improvements

Mehata¹,

Paudel

Dariang

et al. 2017

BioMed Research International

Self Cite

View full text Add to dashboard Cite

Background Nepal has made significant progress against the Millennium Development Goals for maternal and child health over the past two decades. However, disparities in use of maternal health services persist along geographic, economic, and sociocultural lines. Methods Trends and inequalities in the use of maternal health services in Nepal between 1994 and 2011 were examined using four Nepal Demographic and Health Surveys (NDHS), nationally representative cross-sectional surveys conducted by interviewing women who gave birth 3–5 years prior to the survey. Sociodemographic disparities in maternal health service utilization were measured. Rate difference, rate ratios, and concentration index were calculated to measure income inequalities. Findings The percentage of mothers that received four antenatal care (ANC) consultations increased from 9% to 54%, the institutional delivery rate increased from 6% to 47%, and the cesarean section (C-section) rate increased from 1% in 1994 to 6% in 2011. The ratio of the richest and the poorest quintile mothers for use of four ANC, institutional delivery, and C-section delivery were 5.08 (95% CI: 3.82–6.76), 9.00 (95% CI: 6.55–12.37), and 9.37 (95% CI: 4.22–20.83), respectively. However, inequality is reducing over time; for the use of four ANC services, the concentration index fell from 0.60 (95% CI: 0.56–0.64) in 1994–1996 to 0.31 (95% CI: 0.29–0.33) in 2009–2011. For institutional delivery, the concentration index fell from 0.65 (95% CI: 0.62–0.70) to 0.40 (95% CI: 0.38–0.40) between 1994–1996 and 2009–2011. For C-section deliveries, an increase in concentration index was observed, 0.64 (95% CI: 0.51–0.77); 0.76 (95% CI: 0.64–0.88); 0.77 (95% CI: 0.71–0.84); and 0.66 (95% CI: 0.60–0.72) in the periods 1994–1996, 1999–2001, 2004–2006, and 2009–2011, respectively. All sociodemographic variables were significant predictors of use of maternal health services, out of which maternal education was the most powerful. Conclusion To increase equitable use of maternal health services in Nepal there is a need to strengthen the health system to increase access to and utilization of services among poorer women, those with less education, and those living in remote areas. Beyond the health sector stronger efforts are needed to tackle the root causes of health inequality, reduce poverty, increase female education, eradicate caste/ethnicity based social discrimination, and invest in the development of remote areas.

show abstract

Inequalities in the Use of Family Planning in Rural Nepal

Cited by 21 publications

References 15 publications

Equity and Coverage in the Continuum of Reproductive, Maternal, Newborn and Child Health Services in Nepal-Projecting the Estimates on Death Averted Using the LiST Tool

Equity and Coverage in the Continuum of Reproductive, Maternal, Newborn and Child Health Services in Nepal-Projecting the Estimates on Death Averted Using the LiST Tool

General health service readiness and its association with the facility level indicators among primary health care centers and hospitals in Nepal

Trends and Inequalities in Use of Maternal Health Care Services in Nepal: Strategy in the Search for Improvements

Contact Info

Product

Resources

About