RH and safe motherhood indicator in Lumbini Province

1. Supported by:
In partnership with:
RH and safe motherhood status in lumbini
province
Sarashwati Giri
Coverage and Quality Provincial Coordinator

2. Supported by:
In partnership with:
Outline of the Presentation
• Objectives of the session
• CPR rate Modern Method
• LARC new user
• Safe motherhood program Indicator
• MPDSR

3. Contraceptive Prevalence Rate (Modern Methods)
3
47 48 46
43
39 38 36 35
29
35
55
26
43
46 48
45
42 44
38
29
34
28
31
34
25
37
48 47
42 42 41 40
33 32 30 30 28 27
36
0
10
20
30
40
50
60
2075-76 2076-77 2077-78

4. LARC New Users (IUCD & Implant)
4
No implant
services
No IUCD
services
Neither of the LARC
services (IUCD and
Implant)
*Includes Health Posts, PHCCs, all hospitals including Bheri Hospital
Does not include Rapti Academy of Health Sciences
25%
Health Facilities
(152 out of 618)
71%
Health Facilities
(441 out of 618)
23%
Health Facilities
(143 out of 618)

5. Maternal mortality in Hospital in Lumbini province
1
12
0 0
3
9
0
2
0 0
27
1
7
1 1 2
18
4
7
2
6
49
1
8
0
12
1
10
1 1
34
0
8
0 0 0 0 0
4
0
12
0
10
20
30
40
50
60
Palpa mission
Hospital
Universal
Medical college
AMDA Hospital Bhim Hospital Lumbini Zonal
Hospital
Kohalpur
Medical College
Nepalganj
Medical College
Bheri Hospital Lumbini
Medical college
midwestern
hospital
Total Death
Name of Hospital 78/79 Total no of death 77/78 Total no of death 76/77 Total no of death 75/76
5/26/2022 Sarashwati Giri NHSSP 5

6. Safe Motherhood Program Indicators (Lumbini)
• SDG Target
6
110.2
80.2
64.5
60.7
78.8
73.3
99.6
74.4
60.5
52.5
81.4
78.5
97.8
75.2
60.7
54.9
79.6
77
90
0
20
40
60
80
100
120
At least one ANC
visit
1st ANC as
protocol
Four ANC as
protocol
180 Iron tab
received during
pregnancy
% of institutional
deliveries
% of birth
attended by SBA
2075/76 2076/77

7. Safe Motherhood Program Indicators (Lumbini)
7
65.4
75.96
98.93
15
73.4
19.3
59.2
78.34
95.93
16.8
76.3
21.8
64.4
90.63
98.53
17
76.9
29.2
0
20
40
60
80
100
120
Postpartum Vitamin A % of women receiving
ANC incentives
% of women receiving
maternity incentives
% of C/S deliveries % of first PNC as per
protocol
% of 3 PNC as per
protocol
2075/76 2076/77 2077/78

8. Percentage of pregnant women who had Four ANC Visits as
per protocol (FY 2077-78)
9
Dang (50.6)
Kapilbastu (54.9)
Gulmi (56)
Nawalparasi (56.7)
Bardiya (57.1)
Rolpa (62.2)
Pyuthan (63.8)
Palpa (64.9)
Banke (66.6)
Rupandehi (73.4)
50-75% 75-90% >90%
No district No district
Lumbini Province
(60.7%)
SDG Milestone for
2022 (78.7%)
SDG 2030 Target
Rukum-East (45.1)
Arghakhanchi (45.4)
<50%
National
(55.4%)

9. Districts with highest gaps between ANC 1st and ANC 4th Vists (as per protocol)
(as percentage of expected pregnancy)
10
*Absolute difference between percentage of women who had first ANC visit as per protocol and
percentage of women who had four ANC visits as per protocol
23.2 22.7
15.7 15.4 14.8 14.2 13.8
10.8
9.7
8.7 8.5
-0.1
14.5
-5
0
5
10
15
20
25

10. Percentage of Institutional Deliveries (FY 2077-78)
11
Arghakhanchi (29.1)
Nawalparasi (41.7)
Gulmi (44.9)
Bardiya (53.7)
Rukum-East (55.6)
Kapilbastu (59.5)
Dang (60.8)
Rolpa (68.2)
<50% 50-69% 70-90% >90%
Pyuthan (74.7)
Palpa (88.2)
Rupandehi (118.8)
Banke (139)
SDG Milestone for
2022 (71.4%) SDG 2030 Target
Lumbini Province
(79.6%)
National
(64%)

11. Percentage of Women who had 3 PNC Checkups as per
protocol (FY 2077-78)
12
Kapilvastu (16.9)
Rupandehi (22.1)
Nawalparasi (24)
Arghahanchi (24.5)
Dang (26.5)
Palpa (29.8)
Bardiya (30.7)
Banke (36.4)
Gulmi (21.2)
Pyuthan (46.1)
Rukum East (46.8)
Rolpa (56.9)
<50% >50-70% 70-90% >90%
None None
SDG 2030 Target
Lumbini Province
(29.2%)
Absolute gap of 60.8% to be bridged in 8 years time
Rolpa (56.9)
>50-70%
National
(25%)

12. Maternal Deaths in Hospitals
14
5
0
1
0 0
13
0
3
2
1
12
3
2
0 0
0
2
4
6
8
10
12
14
Bheri Hospital Lumbini Provincial
Hospital
Pyuthan Hospital Kapilbastu Hospital Rapti Academy of
Health Sciences
2075-76 2076-77 2077-78
Of all maternal deaths in the province
occurred in hospitals (FY 2077-78)
Highest
• Nepalgunj Medical College, Kohalpur-17
• Bheri Hospital, Banke- 12
68%
Total Maternal Deaths
• Public Hospital (Central): 12
• Public Hospitals (Provincial): 5
• Private Hospitals/Medical Colleges: 32
• Hospitals Total: 49
• Province Total: 72

13. 539
281
259
125 116 99
70
0
100
200
300
400
500
600
NFHS
1996
NDHS
2006
NDHS
2016
NPC
2020
NPC
2022
NPC
2025
SDG
2030
2035
MMR 1996-2016, and Targets to 2030
5/26/2022 Sarashwati Giri NHSSP 15

14. Status of MMR and Neonatal Death in health facility Level
8
11
235
35
9
8
277
37
9
2
213
29
0 50 100 150 200 250 300
Maternal Death-Antepartum
Maternal Death-Intrapartum
Maternal Death-Neonatal death at Health Facility
Maternal Death-Postpartum
Lumbini Province Death Status
Shrawan 2078 to Asar 2079 Shrawan 2077 to Asar 2078 Shrawan 2076 to Asar 2077
Source :DHIS-2
5/26/2022 Sarashwati Giri NHSSP 16

15. Mode of Delivery Among Total Death in Hospital
0
5
10
15
20
25
CS Normal Delivery Asssited Vaginal delivery
25
6
2
5/26/2022 Sarashwati Giri NHSSP 17

16. Causes of Death Among Total MMR
Pre-Eclampsia
19%
Eclampsia
17%
PIH
6%
Puperal sepsis
6%
Anaemia
2%
Heart disease
8%
HIV
2%
APH
4%
PPH
16%
Abortion complication
2%
Ectopic
2%
Covid 19
8%
Pulmonary embolism
4%
Other
4%
5/26/2022 Sarashwati Giri NHSSP 18

17. Period and Time of Death in Hospital
Antepartum
25%
Postpartum
6%
Post partum after 48
hours
69%
Source: MPDSR
5/26/2022 Sarashwati Giri NHSSP 19

18. Age of Death Among Hospital Delivery
20-24 Years
52%
26-30 Years
30%
30-37 Years
18%
Age of Death Among hospital Delivery
20-24 Years 26-30 Years 30-37 Years
Source MPDSR :2078 to 2079
5/26/2022 Sarashwati Giri NHSSP 20

19. Death Ethnicity wise 2077-2079
29%
23%
12%
26%
7% 3%
Terai Madhesi Caste group Brahmin/Chhetri Dalit Janjati Muslim Others
Source: MPDSR
5/26/2022 Sarashwati Giri NHSSP 21

20. Where??Most
transferred from
or on the way to
another Hospital
24%
38%
7%
31%
Pvt/Mission/NGO
Died on the way
from one HF to
another
Died on the way
from home to HF
Died at Home
5/26/2022 Sarashwati Giri NHSSP 22

21. Neonatal Death by Province (NDHS 2016)
36
52
36
27
45
58
69
22
30
17 15
30 29
41
15
31
8
4
19
10
14
0
10
20
30
40
50
60
70
80
Province 1 Province 2 Province 3 Province 4 Province 5 Province 6 Province 7
Newborn and underfive mortality rates by Province
Under 5 Mortality (10 yrs) Neonatal Mortality (10 yrs) Neonatal Mortality (5 yrs)
5/26/2022 Sarashwati Giri NHSSP 23

22. WHY ??: Most of death in Medical College
3%
8%
30%
48%
6% 4% 1%
0%
10%
20%
30%
40%
50%
60%
5/26/2022 Sarashwati Giri NHSSP 24

23. Total Abortion Service Received (District and
Province)
25
17313
18785
17497
16500
17000
17500
18000
18500
19000
Lumbini
2075-76 2076-77 2077-78
1296
2812
2786
3280
1225
1818
868
639
815
1006
768
3602
2898
2177
2576
1384
1630
1101
831
951
982
653
3553
2448
2346
2247
1447
1323
1157
779
778
762
657
0
500
1000
1500
2000
2500
3000
3500
4000
2075-76 2076-77 2077-78

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In partnership with: