Women empowerment usually focuses on things like providing education and jobs. But often, we ignore a crucial aspect—the role high-quality healthcare can provide. Nepal had worked to greatly to reduce the maternal mortality rate from 539 per 100,000 live births in 1996 to 229 in 2016. While this is a remarkable achievement, many women in different parts of the country still need to be airlifted so that they can give birth safely. The latest case is that of Karnali, where helicopter rescue is the only chance of survival for pregnant women. This is a glaring oversight.

There are 274 birthing centres across villages in Karnali Province, yet helicopter rescues to the provincial hospital are the only means of ensuring these women who have birthing complications have successful deliveries. What’s more, according to reports, several women have had to live through difficult pregnancies in their village for lack of a good hospital.

According to the Family Welfare Division, for every 100,000 live births, 229 women still die during or after birth in the country every year. The flagship safe motherhood programme introduced with the aim of reducing maternal and neonatal morbidity and mortality rates brought incentivised packages for mothers to deliver their babies at institutionalised health service providers and opt for free or subsidised check-ups for themselves and their babies, besides giving rural women access to diagnostic tools such as ultrasound. From the last fiscal year, the federal government started the helicopter rescue programme for pregnant or new mothers with complications from remote parts of the country.

But many health centres across Nepal are acutely underequipped. Thirty hospitals across the country, including several district hospitals, lack anesthesiologists and gynaecologists to conduct any surgeries on pregnant women. Health centres, especially in remote areas, are being run by auxiliary health workers and auxiliary midwife. The infrastructure is not proper either. For example, in Mangalsen Municipality-13 in Achham district, owing to lack of requisite infrastructure, women often resort to giving birth at home—a rudimentary and dangerous practice.

The Sustainable Development Goals’ pledge of ‘leaving no one behind’ is a noteworthy mission that focuses on equity. But the chances of realising this goal remain at the margins unless concrete measures are taken to improve access to complete maternal health services. Reproductive rights are not just fundamental rights but also a very sensitive issue. Ensuring safe motherhood and appropriate health facilities during and after pregnancy is the prerogative of the government.

Granted, helicopter rescues have proven effective. But such operations should always be the exception, never the norm. Not everyone can afford to be airlifted for safe and successful delivery. In fact, with the costs involved to airlift women to nearest healthcare centre during their pregnancies being prohibitive, the authorities could have easily invested that amount in building new healthcare centres in required areas or upgraded the already existing centres.

The government has allocated Rs68.78 billion in the budget for the upcoming fiscal year for the health sector, which is 4.48 percent of the total Rs1.53 trillion budget. Perhaps, it could increase spending on something as important as the health sector so that expectant mothers need not feel left behind.

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