LIST OF TABLES AND FIGURES


Table   1. Estimates of Maternal Mortality of selected countries in South Asia
Table   2. Distribution of age of women by the time of their last pregnancy
Table   3. Proportion of women receiving different numbers of antenatal care visits
Table   4. Reasons given by women who did not have any antenatal care visit during their last pregnancy
Table   5. Health problems during most recent pregnancy reported by women household respondent (n=17409)
Table   6. Smoking and antenatal care visits
Table   7. Literacy and antenatal care visits
Table   8. Literacy of household head and antenatal care visits
Table   9. Area of residence and antenatal care visits
Table 10. Literacy and smoking during pregnancy
Table 11. Age at time of pregnancy and antenatal care visits
Table 12. Family support and antenatal care visits
Table 13. Number of previous pregnancies and antenatal care visits
Table 14. Presence of trained TBAs and antenatal care visits
Table 15. Health problems in pregnancy and antenatal care visits
Table 16. Literacy and health problems during pregnancy
Table 17. Working during pregnancy and antenatal care visits
Table 18. Health problems during pregnancy and working during pregnancy
Table 19. Reported sources of antenatal care among 4,040 women with at least 1 visit who could
report the source

Table 20. Reported sources of help for pregnancy problems among 1,574 women who could report the source
Table 21. Type of health worker seen for antenatal care among 4,170 women who could report the information
Table 22. Supply of iron/folate tablets by health facilities and taking iron/folate in pregnancy
Table 23. Provision of tetanus toxoid by health facility and receiving tetanus toxoid in pregnancy
Table 24. Advice reported given by health facilities and TBAs about place of delivery
Table 25. Advice reported given by health facilities and TBAs about breast feeding
Table 26. Reported satisfaction with antenatal care services
Table 27. Perceived problems with antenatal care services reported by 17, 537 women
Table 28. Suggestions for how services could improve antenatal care, from 17,294 women
Table 29. Suggestions for how communities could help pregnancy women, from 17,362 women
Table 30. Suggestions from workers in health facilities on how antenatal care could be improved
Table 31. Place of delivery in rural and urban areas
Table 32. Health problems during pregnancy and place of delivery
Table 33. Literacy of mother and place of delivery
Table 34. Age of women at the time of delivery and place of delivery (deliveries with in the last 5 years)
Table 35. Cost of deliveries among families that spent anything for the last delivery
Table 36. Average cost of delivery by type of facility in Nepali Rupees
Table 37. Average cost of delivery by type of birth attendant
Table 38. Trend of using HDK in the past 3 years (1994-1997)
Table 39. Time since delivery and reported use of HDK
Table 40. Literacy of mother and use of HDK, 1995-1997
Table 41. Having antenatal care visit and use of HDK, 1995-1997
Table 42. Use of HDK by various birth attendant
Table 43. Training of TBAs and use of HDK
Table 44. Practice of TBAs serving the community and use of HDK by households, 1995-1997
Table 45. Literacy and clean cutting the umbilical cord
Table 46. Age of mother and clean cutting of the umbilical cord
Table 47. Time since delivery and use of clean instrument to cut the cord
Table 48. Practice of TBAs in the community and household using a clean instrument to cut the cord
Table 49. Materials used by TBAs to treat the umbilical cord
Table 50. Health problems during labour
Table 51. Health problems during pregnancy and during labour
Table 52. Health problems during labour and place of delivery
Table 53. Health problems during labour seen by TBAs and health facilities
Table 54. Sources of help approached for problems during labour
Table 55. Reasons for not seeking help for problems during labour
Table 56. Proportions of trained and untrained TBAs mentioning different danger signs during labour
Table 57. Causes of maternal deaths and deaths that could have been prevented, as reported by TBAs
Table 58. Mean number of delivery and maternal deaths reported by different health facilities
Table 59. Reported health problems after birth
Table 60. Health problems during pregnancy and after delivery
Table 61. Sources for help for problems after delivery
Table 62. Payment to TBAs for delivery, in Nepali Rupees
Table 63. Training of TBA and use of HDK(1)
Table 64. Training of TBAs and use of HDK (2)
Table 65. Birth weight estimate of last born child reported by mothers
Table 66. Birth weight estimates and time since delivery
Table 67. Literacy of mother and low birth weight
Table 68. Literacy of household head and low birth weight
Table 69. Age of mother and low birth weight
Table 70. Area of residence and low birth weight
Table 71. Family support and low birth weight
Table 72. Number of pregnancies and low birth weight
Table 73. Antenatal care visit and low birth weight
Table 74. Timing of first antenatal visit and low birth weight
Table 75. Iron/folate supplementation and low birth weight
Table 76. Smoking during pregnancy and low birth weight
Table 77. Health problems during pregnancy and low birth weight
Table 78. Satisfaction with antenatal care and low birth weight
Table 79. Training of TBAs serving the community and low birth weight
Table 80. Outcome of last delivery reported by mothers
Table 81. Survival of baby
Table 82. Literacy of mother and survival of baby
Table 83. Literacy of household head and survival of baby
Table 84. Age of mother and survival of baby
Table 85. Family support and survival of baby
Table 86. Smoking during pregnancy and survival of baby
Table 87. Health problems during pregnancy and survival of baby
Table 88. Instruments used to cut the cord and survival of baby
Table 89. Health problem labour and survival of baby
Table 90. Labour hours and survival of baby
Table 91. Estimated birth weight and survival of baby
Table 92. Reported satisfaction with care during labour and survival of baby
Table 93. Health problems of mother and baby after delivery and survival of baby
Table 94. Area of residence and survival of baby
Table 95. Training of TBA and survival of baby
Table 96. Combined Odds Rations and Risk Differences of variables affecting the risk of not attending antenatal care visits from Logistic Regression analysis
Table 97. Combined Odds Rations and Risk Differences of variables affecting the risk of low birth weight from Logistic Regression analysis
Table 98. Combined Odds Rations and Risk Differences of variables affecting the risk of still birth or death soon after birth, from Logistic Regression analysis
Table 99. Possible benefits of different interventions to increase the proportion of women attending for antenatal care
Table 100. Possible benefits of different interventions to decrease risk of low birth weight babies
Table 101. Possible benefits of different interventions to reduce risk of still birth and death soon after birth
Table 102. Intervention affecting several outcomes.


Figures

Figure 1. Age of women at time of last pregnancy
Figure 2. % of women with different number of antenatal care visits
Figure 3. Proportion of women with different levels of satisfaction with antenatal care
Figure 4. Median cost of delivery with and without problems
Figure 5. Median cost of delivery in urban and rural areas
Figure 6. Proportion of births using HDK in relation to birth attendant
Figure 7. % of babies with different estimated birth weights

 

ABBREVIATIONS

Abbreviations:

95% CI  

95% Confidence Interval

AHW  

Auxiliary Health Worker

ANM  

Assistant Nurse Midwife

CBS  

Central Bureau of Statistics

CEDAW  

Convention on Elimination of Discrimination Against Women

FCHV  

Female Community Health Worker

CRC  

Convention on the Rights of the Child

HDK  

Home delivery kit

IMR  

Infant Mortality Rate

MCHW  

Maternal and Child Health Worker

MMR  

Maternal Mortality Rate

NMCG  

National Maternity Care Guidelines Nepal

NMIS  

Nepal Multiple Indicator Surveillance

NPC  

National Planning Commission

OR  

Odds Ratio: one way of estimating Relative Risk (see below)

TBA  

Traditional birth attendant

VHW  

Village Health Worker

UNICEF  

United Nations Childrens Fund

Statistical and epidemiological terms

This report is deliberately written avoiding too many specialised statistical and epidemiological terms. However, some are unavoidable. A brief explanation of the main terms used in the report is given here; readers who are interested in more detailed explanations could refer to a textbook on modern epidemiological methods.

95% confidence interval:
A measure of the accuracy of an estimate, based on the normal distribution curve. The true
value is 95% likely to lie between the upper and lower values of the 95% confidence interval.

Standard Deviation:
A measure of the spread of the distribution of a variable, based on the normal distribution curve. 99% of the population will have values within +/- two standard deviations from the mean value of the variable.

Odds Ratio:
One way of estimating Relative Risk. In a 2X2 table, with cells a,b,c,d, the Odds Ratio is calculated by ad/bc.

Relative Risk:
The risk in one group compared with another group (for example the risk of stunting in girls compared with the risk of stunting in boys). When the actual rates in each group are known (for example, the total number and the number with stunting), the relative risk can be estimated either by the Odds Ratio or by the Rate Ratio (the rate in one group divided by the rate in the other group). In a case-referent study, only the Odds Ratio can be calculated. For relatively rare conditions, the two estimates of Relative Risk give a similar answer. There is discussion about which estimate of Relative Risk it is better to use. For further details, a textbook of modern epidemiology should be consulted. In SCS methodology, the Odds Ratio is used as the estimate of Relative Risk.

The Relative Risk or Odds Ratio gives an idea of the risk for an individual in one group compared with an individual in another group (for example, a child of a literate mother compared with a child of an illiterate mother). It is therefore most useful when making decisions about the most benefit for an individual child (such as those taken by a mother for her child).

Risk Difference:
The risk in one group minus the risk in another group (for example the risk in children of illiterate mothers minus the risk in children of literate mothers). The risk difference can only be calculated when the rates in both groups are known.

The Risk Difference gives an idea of the risk for a group and how this could be changed by an action. It is most useful for planners who are considering how many children could benefit from an intervention.


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