Indeed! Agreed with Rhona Shrestha (British), UK Midwife that we need birthing centre in rural Nepal to needy childbearing women rather than urban areas. However, to do so we need competent, confident, committed and compassion skilled healthcare providers who can provide women-centred holistic care rather than deployed nurses with less competency, lack confident, not committed and having no compassion. Sadly, to date we do not have a professional midwife in the nation, who can provide such care. However, since its establishment Midwifery Society of Nepal (http://www.midson.org.np) together with Ministry of Health and Population, UNFPA and Paroparkar Maternity and Women's Hospital have been working together to bring such cadre in Nepal as per the mandate of the Government of Nepal's National Policy on Skilled Birth Attendant 20006, Long Term (Pre-service) Measures.
"There is in my humble opinion a need to take the fight out of the city and into the hills and mountains...that is where birthing centres and up to date, evidence based antenatal care are needed most. From this report it seems that getting girls and boys into secondary education is failing. An holistic approach to healthcare is needed- from an early age children should be taught about their health and well-being and that needs to continue with discourse throughout their childhood and teen years. We need to empower women beginning with the girls..."-Rhona Shrestha (British), UK Midwife
The Nepal Multiple Indicator Cluster Survey (NMICS) 2011, showcasing household level data on children and women of the Mid and Far Western Regions report highlights the miserable condition of women and children in these regions. As per the survey,
- Exclusively breastfed infants for the first 6 month only around 64% infants.
- Immunized to infant was 56% before their first birthday in the regions, compared to the national average of 81 percent, according to Nepal Demographic and Health Survey (NDHS) 2011.
-56% household members had no toilet facility while only 36 percent were using an improved sanitation facility which is lower than the national average of 56%.
- Only 45% received antenatal care during pregnancies at least once from skilled provider compared to the national average of 58 per the NDHS 2011 while only 29% women delivered by skilled personals compared to the national average of 36%.
- Around 42% of children under 5 years had been birth registered with civil authorities which is equal to the national average while 83% of children between 2-14 years experience violent discipline, including both psychological aggression and physical punishment.
- 44% of children between 5-14 years are involved in child labour in these regions.
- 16% of women aged between 15-49 years got married before their 15th birthday whereas 60% women aged between 20-29 were first married or in union before age 19.
-73% of children of primary school age and 56% of secondary school age attended school.
- Comprehensive knowledge on HIV/AIDS in women only 22% while around 45% of women aged 15-49 years in the Mid-FWR knew where to be tested for HIV.
-Only 5% of women were exposed to all three types of media at least one a week – Radio 49%, television 29% and newspaper 8%.
- 85% of the women had never had alcoholic drink, 7% had had at least one drink of alcohol before the age of 15 years, and 10% had had at least once drink of alcohole on one or more days.
-91% were generally satisfied with their family life, 83% with their current job, 81% with school, self and life in general; 80% with their income; and 77% with their living environment.