It has all the trappings of a good headline as sex, blood, injustice, suffering of the defenseless and guiltless. However, it does not attract much attention in the news media, despite advanced communication technology in our country after the success of the

popular people’s movement in 1990. This is not an exciting story but a tragedy,

this is the story of why thousands of women die

every year in our country during pregnancy, childbirth or after giving childbirth. This is a trend that has to be reversed so that thousands of women’s lives could be saved.

Why is it that the immense suffering that women go through while trying to fulfill their reproductive and social obligation raises no interest in the news media and the sensational or uninspiring stories of phony social workers and politicians dominate the headlines?

It is quite regrettable why the press does not highlight successful and inspiring achievements of the Nepalese, which can be analyzed to prevent the almost “doom and gloom” situation in the country brought in by the so-called progressive revolutionary politicians.

Knowing why women

die during pregnancy goes beyond the number of deaths or knowing incidences of maternal deaths, it is to learn what causes

the deaths and how they

can be prevented. It is for

all service providers in maternal health to know

how women’s lives could

be saved by improving

the quality of health care

delivery.

Successive governments, especially after the1990 successful popular people’s movement, have tried to show commitment in improving maternal and neonatal health in the country. It was in 1991 that Safe Motherhood was identified as a priority programme

in the National Health Policy followed by national

Safe Motherhood Policy in 1994 then the Skilled Birth Attendant(SBA) policy from 2004. Though SBA care cannot aim to copy the developed countries’ concept of care, it is the best in view of our social and economic background.

Till date, the government has not been able to provide adequate SBAs to provide quality maternal and newborn health care according to the national standard and protocol, as not more than 18 per cent of deliveries are attended by health workers during delivery.

In our country the

situation is further complicated by a distribution

bias in delivering medical care to those who need

it least as the urban or middle and upper class of

the population. One burning example is free delivery services provided in

Maternity Hospital in the heart of Kathmandu which is nothing but a populist program of the previous government. This fund could have been used where services are inaccessible for the rural population and the resources

are very limited as in

Jajorkot and in neigbouring areas where hundreds

have died due to diarrhea and are dying every day

due to lack of safe water

and sanitation.

To save our women’s

life during pregnancy,

there is no doubt that the government should ensure the availability, access to and utilization of skilled care at every birth to avoid complications.

For this , poverty alleviation should be the first step that is to effect improvement in socioeconomic status, nutrition and general health of women.

Definitely, poverty

cannot be eliminated overnight, but there should be a policy of equal distribution of development benefits to urban and rural regions, males and females, every section of the society and the realization that there should be basic care that is to provide skilled care and contraceptives to as many women as possible and also provide specialist care to select women.

Obstetricians and professional bodies should also support in empowering nurses to have more SBAs, and female parliamentarians who enjoy perks and good salary at the expense of the general population have not able to show constructive works for the women so far. They should try to play a more prominent role in creating

appreciation of the women’s social and biological

function and of their

contribution. This means a greater allocation of resources to female health and education sectors.

Maternal mortality has decreased in our country through measures to check complications that occur during pregnancy, childbirth or after childbirth but definitely not to the desired level. Women must have access to emergency obstetric care (EOC) for basic care to avoid complications as certain complications as obstetric hemorrhage can kill a woman within hours.

When EOC is accessible or closer to a woman’s residence the chances are that there will be fewer complications like hemorrhage, obstructed labour, eclampsia, unsafe abortion and pueperial sepsis, the major causes of maternal deaths.

Drastic reduction in maternal deaths will be an achievement to boast of. That will be one of the feats realised for the MDGs. Healthy women will be assets of the country capable to look after their children in a manner that will bring prosperity to the country.