TitleHealthy Mothers, Healthy Children: Does Maternal Demand for Antenatal Care Matter for Child Health in Nepal?
AuthorsHalim, N., Alok B., Xiaomin R.
PublicationHealth Policy. 2011 Sep; 26(3):242-256.
AbstractNepal’s Safe Motherhood Programme has failed to deliver expected gains in maternal and child health. Nepalese mothers and their children continue to dispense with (or be denied) antenatal care, experience high maternal mortality rates and suffer chronic malnutrition. We address the correlates and consequences of antenatal care utilization in Nepal by applying two-stage least squares, binomial logit and Heckman selection bias estimates to data drawn from the Nepal Health and Demographic Surveys of 1996 and 2001. Results indicate that maternal education, even at low levels, significantly increases the use of antenatal care; paternal education plays a more important role in the use of routine antenatal care than the conventional wisdom suggests; and when mothers use routine professional antenatal care and maintain good health their children tend to stay healthy through infancy and early childhood. Since health-seeking behaviour is circumscribed by patriarchal gender norms in Nepal, health policies should not only focus on female education and women’s status, but also involve husbands in the process of maternal care utilization.

Key Messages

Years of Safe Motherhood interventions have failed to deliver expected gains in maternal and child health in Nepal, with low use of antenatal services, high maternal mortality and common chronic malnutrition. We found that education, both maternal and paternal, increases routine antenatal care utilization and that child health improves as a result. In the face of strict gender norms, religious and cultural health practices in Nepal, efforts should be made to involve fathers in maternal care, maternal health and child health, in addition to focusing on female education and women’s status.