Nepal’s commitment to reducing, and limiting, maternal mortality to 125 per 100,000 births by 2020 is impossible, according to officials who stress the need for postnatal care.

“The target to limit maternal death to 125 by 2020 is impossible,” said Dr Punya Poudel, the focal person of the ‘Safe Motherhood’ programme at the Family Welfare Division of Department of Health Services. “We are preparing a roadmap to reduce maternal deaths in the future.”

The division’s recent data show that for every 100,000 births, 229 women die during or after childbirth. Nepal had previously reduced the maternal mortality rate from 539 in 1996 to 239 in 2016—for which the country received the Millennium Development Goal award.

According to Poudel, the health target under the UN’s Sustainable Development Goals to reduce maternal mortality rate to 75 for every 100,000 births by 2030 is also unattainable unless effective intervention measures are implemented immediately. “Of the total number of maternal deaths, 24 percent die during or after childbirth and 19 percent in the postnatal period,” she said.

“We are unable to prevent the death of the mother in postnatal period,” said Dr Poudel, who added that most women die of excessive bleeding in the postnatal period. “Postnatal care in health facilities is almost nil. The division plans to send trained nurses to the houses of new mothers to provide postnatal care,” she said.

Dr Sushil Nath Pyakurel, chief specialist at the Ministry of Health and Population, told the Post that government agencies responsible for monitoring the progress of health indicators could not focus on their job due to delays in federal policy implementation.

“The government’s decision to shut down 42 District Public Health Offices was inappropriate, as those units provided incentives of safe motherhood programmes and training to Female Community Health Volunteers and investigated the causes of death,” he said.

Pyakurel added that sending the health budget to provincial and local governments was another mistake, as several local federal units had failed to spend the budget on time. He said that some even spent their health budget on building roads.

“We have now corrected these flaws and are working on a micro plan,” said Pyakurel, who added that the ministry had decided to set up offices in all the 77 districts and training centres in the seven provinces.

According to Pyakurel, early marriage, early pregnancy, frequent pregnancies, and the Chhaupadi tradition in the mid-western and far-western regions of banishing women during menstruation are the major causes of death of new mothers.