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Institute for International Programs

Care Seeking for Newborn and/or Maternal Complications

Systematic Documentation of Community-oriented Approaches to Improve Recognition of and Appropriate Care Seeking for Newborn and/or Maternal Complications in Sarlahi District, Nepal  

Skilled and timely care before, during and after childbirth can save the lives of women and newborn babies from preventable and treatable causes. There are many real and perceived barriers to accessing care, particularly for women in rural areas of low-income countries. Delays in receiving appropriate care can be important for many conditions, but delays of even a few hours in addressing an obstetrical emergency around the time of birth or the onset of sepsis in a neonate can be significant. In rural Nepal, reasons for low usage of free maternal and newborn health facilities remains unclear, despite health policy and programs that have aimed to remove financial and access- to- care barriers to services at primary health care facilities. Understanding the care seeking practice and what drives decisions (both facilitators and barriers) at family and at community levels for maternal and newborn complications is crucial.

This study aims to assess how women and caretakers identify maternal/newborn complications and the factors behind decision-making to seek care, along with an assessment of the quality of maternal and newborn care received at birthing centers and its influence on care seeking behavior and practices in rural Nepal. This is a mix-methods study currently being conducted in Sarlahi District, located in the southern plains of Nepal where the JHSPH affiliated Nepal Nutrition Intervention Project-Sarlahi (NNIPS) research site is located and is nested within an ongoing large community randomized trial. Quantitative and qualitative data on illness recognition, decision making and care seeking behavior are collected through surveys with pregnant women and in-depth interviews and group interviews respectively. In addition, the quality of care of all the birthing centers in the study district is assessed through health facility audit to determine the availability of trained staff, equipment and supplies and through health worker interviews to assess health worker knowledge and training.