By Meghan Gollant
The introduction of health clinics to rural villages in Nepal has vastly improved the health of pregnant women and increased awareness of sexually-transmitted diseases, but challenges remain.
Karnu Gurung has been the village health worker for Tangting village, in Kaski District of Nepal, for 23 years.
“In the 10 years before health post, 12 women died due to complications during or after childbirth,” Ms Gurung said.
“Since I start, there have been no maternal deaths.”
Dr Saroj Pokhrel is a physician at CIWEC Clinic in Pokhara, the closest major city to Tangting village, and said the Health Posts have significantly improved Nepal’s maternal mortality rate.
“It is one of the biggest issues, but our Government invest a lot, and Nepal is one of the countries that has succeeded very much in decreasing the maternal mortality rate.”
According to the Nepal Demographic and Health Survey 2011, two thirds of rural births still take place at home, and only 32 per cent of rural births are delivered by a skilled provider, meaning a doctor, nurse or midwife.
“After delivery they can have infections, and they have lots of bleeding, and then very high maternal and children death rates,” Dr Pokhrel said.
A lack of awareness about maternal health care amongst rural women has contributed to the problem.
“We have lots of education programs…saying you have to go to a health post if you have pregnancy, you have to take medicine, you have to maintain good hygiene,” Dr Pokhrel said.
“But some of the women are not understanding, some of them have to work on the field so they don’t come to the health programs.”
Ms Gurung believes local education does not teach enough about reproductive health, particularly STD’s, family planning and menstruation.
“In schools, they teach but never openly. They teach reproduction but never say the names of the organs. I try to be more clear.”
Earlier this year, Ms Gurung ran a reproductive health program for 86 women from Tangting village.
The program focused on family planning, sexually transmitted diseases and HPV (human papilloma virus).
“I was very satisfied with the program, seven women received IUD (intrauterine device) implants,” Ms Gurung said.
The Health Post in Tangting has not been without its issues. Frequent electricity outages, the most recent lasting six months, make caring for patients difficult.
“I need electricity for heaters to keep the mothers warm, and for fridge to store vaccinations,” Ms Gurung said.
“Medications that need to be frozen I get from Pokhara, and last only 36 hours, so I must go two times a month to get vaccinations for babies and sick people,” she said.
Despite these problems, Ms Gurung has hopes the Health Post will be able to expand in the near future.
“I want to have a bigger birthing centre, and more rooms will allow women to stay longer after childbirth and feel more comfortable.”
