Maternal Health.

Abstract

Reply to two articles in the same New Year’s edition of the Kathmandu Post on maternal health (“Maternal deaths down in poor countries”) and (“Mothers in need”). We felt both are highly relevant to Nepal which is one of the few countries worldwide on target to meet one key element Millennium Development Goal 5, namely to reduce Maternal Mortality by 2015. We are involved in a maternity care improvement project supported by Green Tara Trust (UK) in a rural area 20 km out of Kathmandu. We try to address diverse and changing needs of local communities and make best use of existing heath care resources, whilst at the same time empowering women. Helping to improve the local maternity service provision and advocating its uptake makes it much more likely that the intervention becomes sustainable compared to the introduction of an expensive intervention which is new to the community. Our intervention is evidence-based, and to ensure it is culturally appropriate and acceptable to the local population we have started with an extensive needs assessment. We feel this is important as historically outsiders (national/regional governments or international donor agencies) have made decisions about the needs they perceive to exist. We feel that inequalities between countries and within countries need to be reduced to help improve the health and well-being of the poorest.