Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Feb;24(Suppl 1):22-30.
doi: 10.1007/s10995-019-02828-y.

Equity and Coverage in the Continuum of Reproductive, Maternal, Newborn and Child Health Services in Nepal-Projecting the Estimates on Death Averted Using the LiST Tool

Jeevan Thapa  1   2 , Shyam Sundar Budhathoki  1   2 , Rejina Gurung  2 , Prajwal Paudel  3 , Bijay Jha  4 , Anup Ghimire  1 , Johan Wrammert  5 , Ashish Kc  6   7
Affiliations

Equity and Coverage in the Continuum of Reproductive, Maternal, Newborn and Child Health Services in Nepal-Projecting the Estimates on Death Averted Using the LiST Tool

Jeevan Thapa et al. Matern Child Health J. 2020 Feb.

Abstract

Introduction: The third Sustainable Development Goal, focused on health, includes two targets related to the reduction in maternal, newborn and under-five childhood mortality. We found it imperative to examine the equity and coverage of reproductive, maternal, newborn and child health (RMNCH) interventions from 2001 to 2016 in Nepal; and the death aversion that will take place during the SDG period.

Methods: We used the datasets from the Nepal Demographic Health Surveys (NDHS) 2001, 2006, 2011 and 2016. We calculated the coverage and equity for RMNCH interventions and the composite coverage index (CCI). Based on the Annualized Rate of Change (ARC) in the coverage for selected RMNCH indicators, we projected the trend for the RMNCH interventions by 2030. We used the Lives Saved Tools (LiST) tool to estimate the maternal, newborn, under-five childhood deaths and stillbirths averted. We categorised the interventions into four different patterns based on coverage and inequity gap.

Results: Between 2001 and 2016, a significant improvement is seen in the overall RMNCH intervention coverage-CCI increasing from 46 to 75%. The ARC was highest for skilled attendance at birth (11.7%) followed by care seeking for pneumonia (8.2%) between the same period. In 2016, the highest inequity existed for utilization of the skilled birth attendance services (51%), followed by antenatal care (18%). The inequity gap for basic immunization services reduced significantly from 27.4% in 2001 to 5% in 2016. If the current ARC continues, then an additional 3783 maternal deaths, 36,443 neonatal deaths, 66,883 under-five childhood deaths and 24,024 stillbirths is expected to be averted by the year 2030.

Conclusion: Nepal has experienced an improvement in the coverage and equity in RMNCH interventions. Reducing inequities will improve coverage for skilled birth attendants and antenatal care. The current annual rate of change in RMNCH coverage will further reduce the maternal, neonatal, under-five childhood deaths and stillbirths.

Keywords: Countdown to 2030; Death averted; Maternal, neonatal and child survival; Nepal; Sustainable development goal.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Coverage of RMNCH in different wealth quintile in 2001
Fig. 2
Fig. 2
Coverage of RMNCH in different wealth quintile in 2016
Fig. 3
Fig. 3
Maternal, neonatal, under-five deaths and stillbirth averted by 2030
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Barros, A. J., Ronsmans, C., Axelson, H., Loaiza, E., Bertoldi, A. D., Frana, G. V., … Victora, C. G. (2012). Equity in maternal, newborn, and child health interventions in Countdown to 2015: A retrospective review of survey data from 54 countries. The Lancet, 379(9822), 1225–1233. - PubMed
    1. Bhutta, Z. A., Das, J. K., Bahl, R., Lawn, J. E., Salam, R. A., Paul, V. K., … Walker, N. (2014). Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? The Lancet, 384(9940), 347–370. - PubMed
    1. Boerma, J. T., Bryce, J., Kinfu, Y., Axelson, H., Victora, C. G., Bernstein, S., … Hosseinpoor, A. (2008). Mind the gap: Equity and trends in coverage of maternal, newborn, and child health services in 54 Countdown countries. The Lancet, 371(9620), 1259–1267. - PubMed
    1. Boerma, T., Requejo, J., Victora, C. G., Amouzou, A., George, A., Agyepong, I., … Zaidi, S. (2018). Countdown to 2030: Tracking progress towards universal coverage for reproductive, maternal, newborn, and child health. The Lancet, 391(10129), 1538–1548. - PubMed
    1. Boschi-Pinto C, Black RE. Development and use of the lives saved tool: A model to estimate the impact of scaling up proven interventions on maternal, neonatal and child mortality. International Journal of Epidemiology. 2011;40(2):520–521. doi: 10.1093/ije/dyq171. - DOI - PubMed