MATERNAL HEALTH CARE SERVICE UTILIZATION IN NEPAL: A CASE STUDY OF TARAI REGION

Abstract

Progress in global health awareness has brought changes in the ways in which health was perceived. The 1950s and 60s was a period dominated by technology-driven, vertical programmes with campaigns targeting to specific diseases. Little attention was given towards special issues of health and of particular group. The question about the use effectiveness of medicine alone in the absence of social factors remained as much debatable issue among eminent scholars like Mckeown and Caldwell during those times. Evidences showed that mortality decline in many countries was not only because of advancement in medicines or introduction of smallpox vaccine, but was also associated with rising standards of living, including better diets, improved environmental sanitation, the provision of safe water supplies, elimination of famine as the result of high agricultural productivity and improved communications (Smith 1967 ; Mckeown 1976). From the studies of Sri Lanka, Kerala and Costa Rica, Caldwell concludes that low mortality will be achieved by female autonomy, health and education inputs, health services for all, presence of physician for rural people, nutritional food, universal immunization, concentration in antenatal and postnatal care including birth assisted by health professional and presence of health personnel for decision making in treatment (Caldwell 1986). Therefore, there exists the number of factors to be addressed in developing countries to reduce mortality in the days to come.