Quality Care for Maternal and Neonatal Health (MNH) Services at Primary Health Care Settings in Nepal: A Case Study

Abstract

Maternal and neonatal health (MNH) care service is one of the most important components of Reproductive Health. It is important to improve the reproductive health status through the provision of equitable and high quality health care and health promotion, especially for mothers and children [1]. Maternal and neonatal care service is one of the most important pillars of the Safe Motherhood Initiative. Addressing maternal and neonatal health means ensuring that all women receive the care they need to be safe and healthy throughout pregnancy and childbirth. The health and interests of mother and child cannot be separated [2]. Due to the wide socio-economic differences the high quality reproductive health varies considerably between different regions of the world. Throughout human history pregnancy and childbirth have been major contributors to death and disability among women [3]. The maternal mortality ratio is 7.2/100000 live births in Australia [4], 6/100000 live births in Denmark [5], 30/100000 live births in Sri Lanka [6] and 170/100000 live births in Nepal [7]. Infant mortality rate is still very high, 37 per 1000 live births in Nepal [8]. The neonatal mortality accounts for 23/1000 live births in Nepal [9], whereas in Denmark it is 3/1000 live births, and 5/1000 live births in Sri Lanka [10]. The major causes for maternal deaths are hemorrhage (27.1%), hypertensive disorder (14%), sepsis (10.7%), unsafe abortion (7.9%), embolism (3.2%) and other direct (9.6%) and indirect causes account for 27% in the world [11]. Neonatal deaths are due to prematurity (16%) birth asphyxia (11%), Neonatal sepsis (7%), Congenital anomalies (5%), Pneumonias (3%), Neonatal tetanus (1%) and other causes (3%) [12]. These deaths are associated to three delays and as much as 67.4 % women giving birth die at home due to delay in taking the decision to seek medical assistance; 11.4% die due to delay in reaching appropriate health