Assessment of Health System Performance in Nepal - Ministerial ...

Health System Performance 20104.2 Maternal health outcomesThe results of the analysis suggest that maternal health outcomes have improved as a result ofthe collective effort of different sectors of the government.Figure 4.6: National maternal mortality rate (MMR)Source: MoHP et al (2007)The maternal mortality rate (MMR) is the aggregate measure of maternal health outcomes.While an analysis of MMR by socioeconomic and geographical criteria might be useful forpolicy analysis, the current data does not permit such analysis. Instead, as suggested by AbouZahr and Wardlaw (2001), we took the data on deliveries by skilled birth attendants (SBAs)and caesarean sections (C-sections) to serve as proxy indicators of maternal health.4.2.1 Deliveries assisted by a skilled birth attendantThe percentage of deliveries assisted by SBAs, including a doctors, nurses, or midwives, isone of the indicators of maternal health. The results show that the percentage of birthsdelivered under the supervision of an SBA increased from 9 percent in 1996 to 19 percent in2006. Similarly, the number of C-sections being performed has also risen. There is an inverserelationship between the MMR and the rate of SBA use and C-sections performed. IncreasedSBAs and C-sections reduce the possible death.Figure 4.7: Deliveries assisted by a skilled attendant and C-sectionsSource: MoHP et al (2007), (2002) and (1997)25