FACTORS ASSOCIATED WITH UTILIZATION OF MATERNAL HEALTH SERVICES IN SELECTED MOUNTAINOUS VILLAGES OF KASKI DISTRICT, WESTERN NEPAL

Background: Nepal has the highest maternal mortality rate in the world even though Nepal started and implemented various initiative safe motherhood programs nationally. The main purpose of this study was to identify the related maternal health factors associated with the utilization of Antenatal Care Visits (ANC), delivery and Postnatal Visits (PNC). Methods: Community based cross-sectional study was conducted among 200 mothers of reproductive age group who delivered within 2 years of the survey in Dhital and Dhampus villages of Kaski district, Western Nepal. A structured questionnaire was used for collecting the information from the participants. Data analysis was done by chi-square test and multivariable logistic regression. Results: The findings from the study showed that the coverage of ANC visit was 98% and among them only half of the women visited 4 ANC visits as recommended by the government of Nepal. Out of total respondents, 80% of the respondents delivered in the hospital by Skilled Birth Attendant (SBA) and only 24% visited PNC after the delivery. Age of the respondent, husband education, respondent education, income status, level of maternal knowledge and level of enabling factors were statistically significant and positively associated in bivariate analysis. Multivariate analysis showed age, occupation of respondent, level of maternal health knowledge; enabling factors were positively significant after controlling the variables. Conclusions: The coverage of the maternal health service is still low in mountainous village of Nepal even though free maternal health services are provided with the incentives. This study just identified some factors associated with utilization of maternal health services in mountainous villages of Nepal. Further and deep investigation is necessary to go in the details by the concerned authority to find actual scenario of the mountainous part of Nepal in relation with the maternal health services.