FACTORS DETERMINING THE UTILIZATION OF MATERNAL HEALTH CARE SERVICES IN NEPAL

Abstract

Nepal has made an enormous progress in declining maternal mortality and increment in utilization of various maternal health related services. However, there is still a large group of women left behind without access towards maternal health services and maternal mortality is still high if compared to other developed nations. This study aims to find out what are the various determining factors that are responsible for utilization or non- utilization of maternal health care services in context of Nepal. A scoping literature review was used as a method of study where various published journal articles and documents related to maternal health in Nepal were studied and analysed for the derivation of results and discussion. The analysis was based on Andersen’s Behavioural Model for health service utilization, various factors like socio-cultural, physical and economic accessibility and perceived need were identified as major determinants for utilization/non-utilization of maternal health care in Nepal. This study shows the huge disparity in the utilization of maternal health care services among women in rural and urban areas because of above mentioned factors. The government of Nepal in collaboration with various national and international partner is running various programs related to maternal health for coverage and utilization of maternal health care services in Nepal. However there seems to be lack of effort in addressing socio-cultural factors in relation to health care delivery system. Nepal must now focus on sustaining the major priority towards improvement in overall maternal health and should focus on growing financial, structural and human resources to improve the coverage of maternal health services and community -based approach to meet the need of marginalized population specially women from remote areas.