Healthcare in rural Nepal has always been a great challenge due to its difficult terrains and landscapes. Due to the lack of adequate public transportation pregnant women in remote areas of Nepal face difficulties in reaching health facilities and often end up giving birth on the way. Some women are fortunate to find medical help along the way.
By Julie Colthorpe
In a case study published in the journal Case Reports in Perinatal Medicine, general practitioner Sandesh Pantha describes the struggle of a young pregnant woman who was unable to reach a health facility before going into labour. Pantha and her medical team were able to intervene and carry out the safe delivery of her baby on the side of a highway in one of the most remote areas in far western Nepal, some 1000km away from Kathmandu.
“We waited two hours. No-one gave us a lift”
Together with her husband, the young woman had set off on foot to the health clinic to deliver her baby but was unable to complete the journey due to labour pain. “My labour started yesterday evening. We walked for two hours to reach the highway and for one more hour along the highway; I can’t walk anymore,” said the 25-year-old pregnant woman. “We waited nearly two hours for the vehicle. Few packed pickup cabs passed by, but no-one provided a lift to us,” added her husband.
Pantha and her team of medics spotted the young woman on the highway and stopped to help her. On examining the woman, the general practitioner could see the woman was about to deliver the baby. With the next health facility a 15 minute drive away, she decided to deliver the baby there and then. Within 10 minutes, the young woman delivered a baby boy without any complications.
High maternal mortality rate
This case is representative of many women who are not able to reach a hospital for safe delivery in Nepal. Due to its difficult terrains and landscapes, healthcare in rural Nepal has always been a great challenge, especially for people living in the hills. Nepal is a country with high maternal mortality rate (MMR).
Although the country has improved dramatically in reducing MMR, research on maternal mortality in Nepal showed 90% of maternal mortality occurred in the rural areas; with 11%–14% of these deaths occurring during transfer to health facilities. Some of these deaths can be prevented with improved transportation facilities.
Pregnant women in rural Nepal still find it difficult to get safe maternity services. It thus plays an important role in the high maternal morbidity and mortality in these areas. Easy access to transportation to ensure safe institutional delivery services at birthing centres in rural Nepal, especially in the mountains and hills, is still a herculean task for people living there.
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