Nepal has made considerable progress in achieving Millennium Development Goals (MDG) 4 and 5.However, the progress is uneven at sub-national, developmental and ecological regions and in the population of different socio-economic status. Further the analysis of maternal deaths revealed that nearly 83% of women still die due to direct causes. The three main causes being post partum haemorrhage (32%), hypertensive disorders of pregnancy (25%) and abortion (13%) and 2/3rd of the infant deaths occur during neonatal period. These facts make it clear that without improved skilled birth attendants (SBAs) availability and utilization addressing direct causes of maternal deaths, further reduction in maternal mortality and neonatal mortality is extremely unlikely. This situation also co-relates with the current status of low SBA service coverage at the time of delivery (45.3%). In response to such situation, Nepal government has put more emphasis on implementation of SBA policy and scaling up of its service coverage to meet the targets of MDG 5 and 4 by 2015.
To scale up SBA coverage and meet the targets of SBA policy, it is vital to identify and overcome the barriers and constraints in implementing this policy. In this regard Nepal Public Health Foundation has been implementing this research to assist in scaling up the SBA utilization by removing the identified barriers through proper modalities.
- To facilitate scaling up of SBA services in low coverage districts of Nepal by identifying and overcoming the barriers to their utilization.