Himalayan News Service

Kathmandu, April 10:

Severe bleeding is the single most important cause of maternal mortality accounting for one-third of maternal deaths worldwide. In Nepal, it accounts for 46.3 per cent of maternal mortality. "Some infrastructure has been developed and training of female health workers at the community level is underway," said Dr Yashobardhan Pradhan, director of Family Health Division, addressing the eighth national conference of Nepal Society of Obstetrics and Gynaecology. "However, the fact that some 90 per cent of deliveries still occur at home in absence of skilled medical attendant, is a major challenge."

The maternal mortality in the country of 539 per 1,00,000 live births is one of the highest in the South Asian region and the world. Poverty, low literacy, low social status of women and cultural barriers are said to be some of the major causes of this. Dr Pradhan said to check this the less skilled health and traditional attendants could be paired with skilled attendants.

Dr Harshad Sanghvi, medical director of JHPIEGO -- an affiliate of John Hopkins University, cited experiences from Indonesia, where they witnessed significant reduction in deaths due to post-partum haemorrhage after distributing a drug called misoprostol to be used after delivery at the community level.

"For immediate intervention, we launch pilot projects distributing misoprostol to selected communities," said Dr Pradhan, talking to The Himalayan Times. Commenting on the challenges after legalisation of abortion in Nepal, Dr Bimala Lakhey said there was need to develop skilled manpower and make medical facilities accessible to the rural poor. Dr Ganga Shakya, reproductive health section chief at the Family Health Division, opined that nurses could play a significant role in preventing and managing post-partum haemorrhage through basic emergency obstetrics care training.

At the inaugural session, Minister of Health Dr Bhekh Bahadur Thapa, gave away letters of commendation to Dr Ufe Shah, Dr Asha Singh and Dr Shanti Joshi from the adolescent clinic at the Bir Hospital. Health secretary Lok Man Singh Karki launched a training booklet on health and development of youth. The honorary membership of the society was awarded to Dr Rita Thapa, Dr BD Chataut and Dr Laxmi Raj Pathak. Dr Shova Khatri and Dr Mahodadhi Shrestha were honoured with the senior gynaecologist awards.