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An Appraisal of the Maternal Mortality Decline in Nepal

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  • Julia Hussein
  • Jacqueline Bell
  • Maureen Dar Iang
  • Natasha Mesko
  • Jenny Amery
  • Wendy Graham

Abstract

Background: A decline in the national maternal mortality ratio in Nepal has been observed from surveys conducted between 1996 and 2008. This paper aims to assess the plausibility of the decline and to identify drivers of change. Methods: National and sub-national trends in mortality data were investigated using existing demographic and health surveys and maternal mortality and morbidity surveys. Potential drivers of the variation in maternal mortality between districts were identified by regressing district-level indicators from the Nepal demographic health surveys against maternal mortality estimates. Results: A statistically significant decline of the maternal mortality ratio from 539 maternal deaths to 281 per 100,000 (95% CI 91,507) live births between 1993 and 2003 was demonstrated. The sub-national changes are of similar magnitude and direction to those observed nationally, and in the terai region (plains) the differences are statistically significant with a reduction of 361 per 100,000 live births (95% CI 36,686) during the same time period. Conclusion: It is likely that there has been a decline in Nepal's maternal mortality since 1993. This is good news for the country's sustained commitments in this area. Conclusions on the magnitude, pattern of the change and drivers of the decline are constrained by lack of data. We recommend close tracking of maternal mortality and its determinants in Nepal, attention to the communication of future estimates, and various options for bridging data gaps.

Suggested Citation

  • Julia Hussein & Jacqueline Bell & Maureen Dar Iang & Natasha Mesko & Jenny Amery & Wendy Graham, 2011. "An Appraisal of the Maternal Mortality Decline in Nepal," PLOS ONE, Public Library of Science, vol. 6(5), pages 1-10, May.
    • Handle: RePEc:plo:pone00:0019898
    DOI: 10.1371/journal.pone.0019898
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    Cited by:

    1. Lisa Cameron & Diana Contreras Suarez & Katy Cornwell, 2019. "Understanding the determinants of maternal mortality: An observational study using the Indonesian Population Census," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-18, June.
    2. Anita Makins & Jochen Ehmer & Alexandra Piprek & Francisco Mbofana & Amanda Ross & Michael André Hobbins, 2019. "Demand-side financing in the form of baby packages in Northern Mozambique: Results from an observational study," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-12, May.

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