ArticleJournal of health, population, and nutrition2018
Health system barriers influencing perinatal survival in mountain villages of Nepal: implications for future policies and practices.
Article in Journal of health, population, and nutrition, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 18 citations in OpenAlex.
- From Village to Clinic: Structural Barriers and Intersecting Challenges in Maternal Healthcare Access in Rural Nepal.International journal of environmental research and public health · 2026Article
- Reducing Neonatal Mortality in Nepal's Remote Regions: A Narrative Review of Challenges, Disparities, and the Role of Helping Babies Breathe (HBB).Pediatric reports · 2025Review
- Improving the quality of maternal and newborn healthcare at the district level: Addressing newborn deaths in Nepal.PLOS global public health · 2023Article
- Investigation of technical quality of antenatal and perinatal services in a nationally representative sample of health facilities in Nepal.Archives of public health = Archives belges de sante publique · 2022Article
- Cross-sectional study on knowledge and attitude of telemedicine in medical students of Nepal.Health science reports · 2022Article
- Respectful Maternity Care in South Asia: What Does the Evidence Say? Experiences of Care and Neglect, Associated Vulnerabilities and Social Complexities.International journal of women's health · 2022Review
- Article
- Evidence on access to healthcare information by women of reproductive age in low- and middle-income countries: Scoping review.PloS one · 2021Article
- Article
- A critical account of the policy context shaping perinatal survival in Nepal: policy tension of socio-cultural versus a medical approach.BMC health services research · 2019Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis paper aims to examine the health care contexts shaping perinatal survival in remote mountain villages of Nepal. Health care is provided through health services to a primary health care level-comprising district hospital, village health facilities and community-based health services. The paper discusses the implications for future policies and practice to improve health access and outcomes related to perinatal health. The study was conducted in two remote mountain villages in one of the most remote and disadvantaged mountain districts of Nepal. The district is reported to rank as the country's lowest on the Human Development Index and to have the worst child survival rates. The two villages provided a diversity of socio-cultural and health service contexts within a highly disadvantaged region.
methodsThe study findings are based on a qualitative study of 42 interviews with women and their families who had experienced perinatal deaths. These interviews were supplemented with 20 interviews with health service providers, female health volunteers, local stakeholders, traditional healers and other support staff. The data were analysed by employing an inductive thematic analysis technique.
resultsThree key themes emerged from the study related to health care delivery contexts: (1) Primary health care approach: low focus on engagement and empowerment; (2) Quality of care: poor acceptance, feeling unsafe and uncomfortable in health facilities; and (3) Health governance: failures in delivering health services during pregnancy and childbirth.
conclusionsThe continuing high perinatal mortality rates in the mountains of Nepal are not being addressed due to declining standards in the primary health care approach, health providers' professional misbehaviour, local health governance failures, and the lack of cultural acceptance of formalised care by the local communities. In order to further accelerate perinatal survival in the region, policy makers and programme implementers need to immediately address these contextual factors at local health service delivery points.
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Registered trials
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