Factors Affecting the Uptake of Institutional Delivery, Antenatal and Postnatal Care in Nawalparasi District, Nepal.

Background Maternal deaths and complications are highly preventable with good antenatal, postnatal and skilled care during childbirth. Inadequate information on the factors affecting these services could be barrier to a reduction of maternal deaths in lowincome countries. Objective To assess the uptake of antenatal, postnatal and skilled care during childbirth. Method A cross-sectional study was conducted in eight villages of Nawalparasi district in southern Nepal. A total of 447 women who had given birth within the preceding 24 months were recruited using multistage random sampling. Data were collected using a pre-tested semi-structured questionnaire. Chi-square tests were used to assess association between variables. Result Over 70% of women had gone for at least four antenatal care check-ups while only 14.3% had at least three postnatal check-ups in their last pregnancies. The proportion of institution delivery was 54%. Women's literacy was associated with the uptake of antenatal services (p=< 0.001), postnatal care (p=0.04) and institutional delivery (p=< 0.001). Knowledge of antenatal (p=< 0.001) and postnatal care was also associated with uptake of respective services (p=< 0.001). Conclusion The uptake and knowledge of antenatal care was much better than of postnatal care. Home delivery rates were still very high. A scaling-up of education and awarenessraising interventions in this community could help improve the uptake of maternal health services.