Variability in access to antenatal care and birthing practices in rural Humla District, Nepal

Globally, nearly 800 women die daily due to pregnancy and childbirth complications. There is limited research on maternal health practices in remote mountainous regions in Nepal, where access to maternal care is severely limited by geography. The paper explores the circumstances surrounding the execution of safe motherhood initiatives in rural Nepal, including barriers and facilitators to improved care. This study assesses the utilization of antenatal care (ANC), frequency of ANC visits, and presence of a skilled attendant at an institutional delivery in the Karnali Province of Nepal, specifically the Humla District. The study compares the utilization of maternal health services across four groups: 1) three villages in the Humla District with non-governmental organization (NGO) supported health care facilities, 2) three villages in the Humla District without NGO-supported health care facilities, 3) the Karnali Province, and 4) nationally. The findings suggest that while NGO-supported interventions can improve access to ANC, barriers such as facility availability, geographic isolation, and cultural norms continue to limit institutional delivery rates. This study provides insight into the multiple factors influencing maternal healthcare in remote Nepal and highlights the need for a more comprehensive approach to improving maternal health outcomes that addresses both healthcare access and cultural practices.