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The Kaski district court on Sunday remanded former Deputy Prime Minister and chairperson of Rastriya Swatantra Party (RSP) Rabi Lamichhane, an accused in a cooperatives scam, in custody for six days amid protests in support of and against his arrest.

Responding to an arrest warrant from Kaski district authorities, a team from the Nepal Police’s Central Investigation Bureau (CIB) had arrested Lamichhane from the RSP central office in Banasthali, Kathmandu, on Oct 18 for further probes into the scam and dispatched him to face the court in Pokhara (Kaski).

Meanwhile, police intervened in the demonstrations of RSP supporters opposing Lamichhane’s arrest by firing water cannons and teargas canisters in Pokhara as they reportedly sought to enter a ‘prohibited area’. 

Kaski district administration office had issued prohibitory orders declaring Shahid Chowk and Gaihrapatan of ​​Kaski a prohibited area by banning any group of more than five people from entering the area and disallowing all kinds of demonstrations and processions there. 

It should be noted that while the supporters of Lamichhane were protesting against his arrest, victims of different cooperative scams were staging protests demanding legal action against those involved in such scams.     

Lamichhane’s arrest follows a probe report from the Parliamentary Special Committee on Cooperatives that recommended legal action against several persons, including the then managing director of Gorkha Media Network Pvt Ltd Lamichhane, its chairperson GB Rai, member Kumar Ramtel and director Chhabiraj Joshi, for “illegal transfer and misappropriation of the cooperatives’ funds”, a charge Lamichhane has denied repeatedly. Police have already arrested Joshi while Ramtel is also in custody. 

The report states that Gorkha Media had misappropriated money deposited at nine cooperatives— Suryadarshan (based in Pokhara), Supreme (Butwal), Swarnalakshmi (Kathmandu), Sahara (Chitwan), Sanopaila (Birgunj), Image, Samana, Sumeru and IME.

The report has also recommended the immediate arrest of the others accused in the case—Gitendra Babu (GB Rai), Than Bahadur Budha Magar, Dinesh Rokka, Sagar KC, Pichkan Khatun and Bhupendra Rai.

The number of people infected with dengue is rising across Nepal. According to a report published by the Epidemiology and Disease Control Division (EDCD) on June 18, a total of 1,241 people have contracted dengue since January this year. The division reports that dengue has been detected in 72 districts countrywide, while no cases have been reported in Mustang, Dolpa, Mugu, Humla, and Jumla. Despite this, the fear of the disease spreading persists.

Dengue is a vector-borne disease carried by female Aedes aegypti mosquitoes and, to a lesser extent, Aedes albopictus. These mosquitoes also transmit chikungunya, yellow fever, and Zika virus.

The EDCD data shows 141 cases in Kathmandu, 112 in Jhapa, 75 in Chitwan, 59 in Makwanpur, 47 in Doti, 46 in Tanahu, 44 in Sindhupalchok, 41 in Okhaldhunga, 28 in Rupandehi, 27 in Bhaktapur, and 18 in Lalitpur since January. These are the top 10 districts with the highest number of dengue cases. The Bagmati province has reported 428 cases, the highest cases this year.

Garbage in the city provides perfect breeding spots for mosquitoes to lay their eggs, with discarded plastic cups, bottles, and bottle caps being prime locations. The EDCD report reveals that dengue is spreading faster than last year, primarily due to the increasing mosquito population. Warm temperatures and rainfall create ideal breeding conditions, and mosquitoes bite multiple individuals, thus increasing the number of infections, said Dr. Sher Bahadur Pun, chief of the Clinical Research Unit at Sukraraj Tropical and Infectious Disease Hospital at Teku, Kathmandu.

Dengue symptoms usually begin 4–10 days after infection and last for 2–7 days. Symptoms may include high fever (40°C/104°F), severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands, and rash.

August, September, and October have historically seen the highest number of dengue cases in the country. Last year, 14,534 cases were reported in August, 13,912 in September, and 12,699 in October. As cases begin to rise again, we are likely witnessing a pre-outbreak, which could lead to widespread infection, said Dr Pun.

According to the World Health Organization, urbanization, especially unplanned, is associated with dengue transmission through various social and environmental factors, including population density, human mobility, access to reliable water sources, and water storage practices. Community risk is also influenced by a population's knowledge, attitudes, and practices regarding dengue, including behaviors related to water storage, plant keeping, and self-protection against mosquito bites.

The Ministry of Health and Population recommends three ways to control dengue: search and destroy possible mosquito breeding sites, protect yourself from mosquito bites, and seek immediate medical attention if you exhibit any symptoms of dengue.

The government must act immediately to curb the infection. Immediate health plans are necessary to reduce the number of infections. Last year, 52,790 people were affected, with 20 deaths. Without timely action, the number of infections could increase significantly.

As the whistle blew and the green flags were waved near the start line outside the building of United Traders Syndicate Pvt Ltd, distributor of Toyota in Chabahil, 55 women who were seated in the driving seat cheerfully drove their cars along with their navigators. These women were there to participate in the Toyota Women’s Rally organized by United Traders Syndicate Pvt Ltd to celebrate women’s achievement in motorsports and promote safe driving.

As the checkered flag waved at the Gokarna Forest Resort the women were welcomed with a garland for completing the rally. The women had reached the resort after completing the 30 km distance that took the route of United Traders Syndicate building, Narayan Gopal Chowk, Bhatbhateni Temple, Jamal, Newroad, Bhadrakali Temple, Tripureshwor, Baneshwor, Tinkune, Airport, Gaushala, Chabahil Jorpati and Gokarna Forest Resort.  

Rajyalaxmi Shakya, bagged the first position and won Rs 50,000 cash, trophy and gift hampers. Rinchen Lama came in second and was awarded a purse of Rs 30,000, trophy and gift hampers. Similarly, Swastika Maharjan won the third prize with Rs 20,000 cash, trophy and gift hampers.

The winners were selected on the basis of fulfilling the criteria such as time limit, road safety standards and compliance with the traffic rules. The rally was judged by the officials of Nepal Automobiles’ Association (NASA).

Since its inception in 2004, the Toyota Women’s Rally in Nepal has been a beacon of progress—-celebrating women’s achievement in motorsports. It stands as a testament to breaking stereotypes and fueling inspiration in the country.

“The objective of organizing the event is to acknowledge the achievements of women. We see the great confidence, the willingness, the entrepreneurship of the women who are here and this is what we want the world to know,” said Ritu Singh Vaidya, managing director of UTS.

“I participated in the 2011 rally too and finished in a good spot. The event is more about women participation and empowerment. I believe women should not just compete in women-centric competitions. They should compete with men too. It is good to see the growth of women drivers. I loved the event,” said Saguna Shah, one of the participants. 

Gyanu Adhikari’s ‘Sambedanako Samayog’ is a collection of essays. Divided into seven chapters the collection has a variety of essays ranging from personal experiences of the writer, her memories of teaching elderly women in her village, the life of students in Kirtipur, raises issues of females, her travel experiences, and her sources of becoming a writer, among many others.

Written in a simple language, the essays evoke nostalgic memories of the past. Use of sentence structures to make the readers feel the event and sequences, vivid description of the place and events give a reader an appeal to sight, sound, touch, taste and smell.

Making a comparison of the writer with the other women in the society, Adhikari aptly explains the problems and challenges of the working women, struggling to balance the work and family life. ‘Asamyak Sparsha’ is about the personal experience of being a mother and her difficulties in taking care of the child. Her question “Did I become a successful mother?” is not only the question of Adhikari but is a question that many mothers might ask themselves when they leave their child home and go to work. It depicts the problems of women not being with the child in his/her needs despite them running to make a living for the family. Her essays advocate women empowerment.

The essayist in her experience of residing in Kirtipur has come up with fun filled memories of the place. She depicts the life of the students who have rented the rooms in the houses in Kirtipur. She perfectly narrates the life of the students’ struggle of living in Kathmandu—how they are struggling to make a living, living their life in limited income, water, their struggles to prepare for the examinations to enter the government jobs, the limited number of items in their rooms and their techniques for interior designs.

She narrates about the Tribhuvan University and also satires on how the university itself is looking for its history. She says that the central departments in the university have not been functioning properly. She compares the university with a surrogate mother who cannot love the child she has given birth to. The university too is like a surrogate mother—people come here to study, they study, get the degree and go away, never to be seen back in the premises again.

She explains about the historical importance of the old city.

She describes the change of the tenants in the households after the change of the curtains on the windows and also describes the people living there in the rents. Some are serious, while some are lazy. She unwillingly has to listen to the conversations of the students. Use of dialogues in the direct speech in the text has given the essays a real feeling. She too hears the conversations of the students expressing their happiness after them receiving their visas for abroad studies/jobs. She narrates how the students cook at midnight, wash the dishes and sing when Kathmandu is sleeping. She concludes that we can know about the person from the daily activities that s/he does. She narrates the stories that take place inside the rooms of the students in a lively and vivid manner.

Seema Bhanda Para Failidai is a travelog. She narrates about her first experience of seeing a sea, her excitements after being in the see, watching Kanchanjungha mountain her dissatisfaction about the maltreatment of Nepalis in Jaggannath Puri in India by the pandas (the priests around the temple), and her experiences of being in a group of drunkard colleagues. The selection of words and formation of the sentences in the essay ‘Ramailoko Paribhasa’ gives you an exact image of the situation where one who does not drink becomes the onlooker rather than being a participant of the group. The feeling of nationality emerges when one sees and crosses the Tista River in India. Being grown up listening to the song with words ‘Paschim Killa Kangada, Purvama Tista Pugetheu’ the feeling of nationality is overcome when one reaches the river. The writer has aptly portrayed this sentiment in her essay ‘Tista Nadi Matra Hoina Rahecha’ and she is right about it.

She pens downs about the literary figure Shivahari Adhikari. She raises her concern on how the new generation is unaware about the literary figures and their contributions in literature. She unknowingly advises the government and the concerned bodies to save the works of the writer. Her essay in the chapter ‘Shabda ra Aksharharuma’ is about how reading is a spiritual act. Two essays on this last chapter is a research work on which talks about the use of reality and realism in Nepali literature. Those who are not the students of Nepali students are likely to feel the part is boring as it is more technical and is a research based article.

There are a few errors and typos in the text. Though the essays are written in simple sentences there are multiple questions. It seems the writer is trying to seek the answers. Use of multiple questions in the essays though are thought provoking, the use of more questions makes you why there is a question again. The reader finds it unnecessary.

The movie ‘Annapoorani’ advocates for women empowerment but a failure to execute the plot on many levels takes away from the story and leaves you feeling baffled. 

The story is female centric. Annapoorani (played by Nayanthara) sheds light on gender issues by entering the culinary business, a business dominated by men. She wants to become an inspiration for many women. 

Annapoorani is born to an orthodox Iyenger family but she is swept away by the aroma of a fish fried on a hot pan by the roadside.

The name Annapoorani means the goddess of food and she does indeed seem to have been born to cook and taste delicious food. There is magic in this girl. She was born with enhanced taste buds that allows her to differentiate flavors really well. 

The movie starts with Annapoorani walking next to her doting father, Rangarajan, (Achyuth Kumar) who is a chef at the Srirangam Ranganatham temple. They are seen carrying freshly made offerings. 

It’s the father’s love for cooking that inspires his daughter to become the best chef in the country like the famous chef Anand Sundarajan (Sathyaraj).

As she grows up she shares her wish to join a culinary school to become a chef. But her father Rangarajan forbids her to join the course, telling that she will have to cook and eat meat. As she belongs to a Hindu vegetarian family, she will not be able to chop chicken and is forbidden to eat meat. Her childhood friend and secret lover Farhaan (Jai) manages to help her join the culinary school despite her father’s disapproval.

Torn between her passion and her father’s orthodox ideologies, she aims to achieve her dream of becoming a corporate chef. Does she succeed? What kinds of difficulties does she face in the journey? 

The pre-intermission has a number of things but all of them are predictable. It’s a typical Hindi masala movie. But it doesn’t captivate you at any point. It feels lame and slow. 

There are many issues in the movie. Her father eventually finds out about her joining the culinary school. She is caught red handed inside the classroom chopping a chicken. The scene is predictable. The scene where Annapoorani lashes out at her landlord is too filmy and mechanical. It’s difficult to enter a five star hotel’s kitchen. But Annapoorani does it in just two scenes and something about this feels off. 

Karthik Kumar, in the role of chef Ashwin, is reduced to being a caricature. He is angry for no reason and doesn’t even hesitate to hit his father with a wine bottle.

The film takes a dramatic turn when Annapoorani loses her tastes because of an accident in the kitchen. Was that really an accident or was it planned? Again, you can guess what happened.

The use of an animated sequence to show a young girl climbing up Everest moving closer to her dreams facing multiple hurdles is well anticipated.

Annapoorani leaving the house when the groom is there on her wedding day reminds of the scenes of 2017 comedy, Raj Kumar Rao starrer, ‘Shaadi Mein Zaroor Aana.’

However, it’s a good inspirational drama. Though there is nothing exceptional in the movie, it’s quite palatable. The film revolves around food and cooking but it has very few mouthwatering visuals of food one expects in such a film.

The film has tried to convey a message of women empowerment. It has heartfelt ideas but the narration feels rushed. The storyline is convenient. The writing is weak and thus the screenplay feels stretched. 

Nayanthara has given her all to the role. Sathyaraj as Chef Anand, a renowned chef who is Annapoorani’s role model, plays the role of a supportive mentor. He seems to be too soft in his role. Jai as Farhaan has very little to do as a chef. Karthik Kumar is the villain in the story. He is envious of the heroine and has to constantly seek validation from his father.

There is a lot of spoon feeding in the film. There are a lot of emotions, but nothing really sticks. The ideas seem to be forced. The film would have been better if it had focused on a particular theme. 

The film speaks about how taste isn’t the only sense that cooking requires but it fails to raise questions on why there isn’t an alternative for chefs to cook non-vegetarian food without having to eat it.

All in all, the movie doesn’t satiate your craving for a good story. 

3 Stars

Drama

Annapoorani

Cast: Nayanthara, Karthik Kumar, Jai, Achyuth Kumar, Sathyaraj, Redin Kingsley

Director: Nilesh Krishnaa

Runtime: 135 minutes

https://www.youtube.com/watch?v=ED-4d0S4Mj0

India saw a single day rise of 656 new cases of coronavirus on Dec 24, pushing the active cases to 3,742 according to the Union Health Ministry. Amid the surge in cases of Covid-19, health experts have asked people to remain calm and follow Covid-appropriate behavior.

In Nepal, health experts have suggested people not to worry about the latest surge of coronavirus infection in India. They say that the mutations of the virus are always evolving, and this is one of the mutations of the omicron variant. 

“Though this strain is circulating faster, it is not very serious. It is not that scary. If you are vaccinated once or twice, or were previously infected there won’t be much severity if you get infected,” said Sameer Mani Acharya Dixit, chairperson and head of research at Intrepid Nepal Pvt Ltd.

The symptoms of the infection are similar to the infection caused by similar other variants of the coronavirus, such as headache, sore throat, fever, etc. Health experts, however, have advised people to take booster shots to prevent oneself from the severity of the infection.

What is JN.1?

JN.1 is a closely-related descendant of BA.2.86, a highly mutated strain that first worried scientists over the summer. BA.2.86 was deemed a “variant of interest” by the World Health Organization back in August.

The UN health body has recently designated JN.1 as a variant of interest, differentiating it from its parent lineage BA.2.86. The WHO defines variants of interest as strains that are worrying enough to trigger stepped up investigations of the variant by countries, like laboratory studies and field investigations of its outbreaks.

Despite its swift dissemination, the WHO has underscored that the overall risk associated with JN.1 is currently considered low based on available evidence.

In recent weeks, JN.1 was reported in multiple countries, and its prevalence has been rapidly increasing globally. But the WHO has maintained that there is no evidence to suggest any additional public health risk posed by the variant.

Concerns triggered

After first being spotted in the United States in September, the variant has spread across 41 countries.

Health experts say the JN.1 is spreading fast in all regions, probably because it has an additional mutation in the spike protein compared to the BA.2.86 variant from which it’s descended.

The outbreak of the JN.1 sub-variant of the coronavirus in India has triggered concerns among the Nepalis. Indian states Kerala, Karnataka, Tamil Nadu, Maharashtra, Goa, Puducherry, Gujarat, Telangana, Punjab and Delhi have reported a slight increase in the number of cases of late. 

According to the Indian media reports nearly 93 percent of those infected have mild symptoms and are isolating at home. Among those who are undergoing treatment at hospitals across the country, only 0.1 percent are on ventilator support, 1.2 percent are admitted into the intensive care unit and 0.6 are on oxygen support.

No need to panic

Nepal currently hasn’t seen a rise in the number of coronavirus cases. The authorities however say that they are closely monitoring the development in India.

“Many people in Nepal have had the infection and people have received at least two doses of the vaccine. Therefore, the probability of severe infection is low,” said Dr Prakash Budhathoki, spokesperson at the Ministry of Health and Population. “Intensive care units, oxygen plants, and other physical infrastructure constructed during the Covid-19 pandemic can be utilized if needed.” 

Following the surge in coronavirus cases, health desks established at checkpoints and international airports have been placed on standby, and a request has been made to place patients with respiratory problems under special supervision.

“As the infection is seen in Kerala, we are relatively at lower risks. If the infection was seen in the southern areas of India that borders Nepal, it would have been quite risky, as there are high chances for the variant to enter the country in a shorter time span,” said Dr Budhathoki. 

He also informed that patients with long-standing respiratory problems have been recommended for gene sequencing. The ministry has also requested health centers to keep a check on the people visiting the hospitals with the symptoms of coronavirus and has asked them to submit a report to the ministry.

“It is anticipated that this variant may cause an increase in Sars-Cov-2 [coronavirus] cases amid a surge of infections of other viral and bacterial infections, especially in countries entering the winter season,” the WHO said in its risk assessment.

The UN health agency also noted that there is still limited evidence on how capable JN.1 is of getting round the immunity offered by vaccines.

Strengthen surveillance

The WHO has urged countries in the South-East Asia region to strengthen surveillance and for people to take protective measures in view of increasing numbers of cases of respiratory diseases, including due to coronavirus and its new sub-variant JN.1, and influenza. 

“The Covid-19 virus continues to evolve, change and circulate in all countries globally. While current evidence suggests the additional public health risk posed by JN.1 is low, we must continue to track the evolution of these viruses to tailor our response. For this, countries must strengthen surveillance and sequencing, and ensure sharing of data,” said Dr Poonam Khetrapal Singh, WHO regional director for South-East Asia. 

Considering the available, yet limited evidence, the additional public health risk posed by JN.1 is currently evaluated as low at the global level. It is anticipated that this variant may cause an increase in Covid-19 cases amid a surge in infections of other viral and bacterial infections, especially in countries entering the winter season.

 Ways to protect

 Health experts have advised people to take protective measures and seek timely clinical care when unwell. They have also urged people with high risk such as elderly citizens, people with comorbid health conditions to take vaccination against coronavirus and influenza.

“All WHO-approved Covid-19 vaccines continue to protect against severe disease and death from all variants, including JN.1,” said Dr Singh. “With Covid-19 continuing to circulate at high levels globally, countries must strengthen surveillance, sequencing and reporting to effectively manage respiratory diseases and to protect people’s health.”

To prevent infections and severe disease, the WHO advises to:

• Wear a mask in crowded, enclosed areas
• Cover up coughs and sneezes
• Clean your hands regularly
• Stay up to date with covid and flu vaccinations, especially if vulnerable
• Stay home if ill
• Get tested if you have symptoms

The government has urged people not to panic about the new variant of the coronavirus identified in India. Health authorities in Nepal say they are closely monitoring the development in India.

India has been seeing a rise in the number of Covid-19 sub-variant JN.1. As per media reports, 614 new Covid cases have been detected in India as of Wednesday. Meanwhile, three people infected with the new variant have died in Kerala, per the reports.

Nepal however hasn’t seen a rise in the number of coronavirus cases as per the Ministry of Health and Population.

The World Health Organisation has designated the new variant as a “variant of interest” separate from its ancestor BA.2.86 that is commonly referred to as Pirola.

WHO maintained that there was no evidence to suggest that the new variant poses additional public health risks.

JN.1 is a closely-related descendant of BA.2.86, a highly mutated strain that first worried scientists over the summer. BA.2.86 was deemed a “variant of interest” by the WHO back in August.

The WHO defines variants of interest as strains that are worrying enough to trigger stepped up investigations of the variant by countries, like laboratory studies and field investigations of its outbreaks.

“Many people in Nepal have had the infection and people have received at least two doses of the vaccine. Therefore, the probability of severe disease is low,” said Dr Prakash Budhathoki, spokesperson at the Ministry of Health and Population.

Problems related to the respiratory system are currently increasing in India and China.

“Intensive care units, oxygen plants, and other physical infrastructure constructed during the Covid-19 pandemic can be utilized if needed,” Dr Budhathoki added.  

Health desks established at checkpoints and international airports have been placed on standby, and a request has been made to place patients with respiratory problems under special supervision.

“As the infection is seen in Kerala, we are relatively at lower risks. If the infection was seen in the southern areas of India that borders Nepal it would have been quite risky as there are high chances for the variant to enter the country in a shorter time span,” Dr Budhathoki said.  

The spokesperson also informed that patients with long-standing respiratory problems have been recommended for gene sequencing.

The ministry has requested health centers to keep a check on the people visiting the hospitals with the symptoms of coronavirus and has asked them to submit a report to the ministry.

When Pansara Rokaya (31) of Kuru village in Budhinanda Municipality-4, Bajura, delivered a baby girl on the way to a local health post recently, it became national headlines. 

Similarly, Bhagya Chadara ( 21) from Majhpali village in Gaumul Rural Municipality-3, Bajura, gave birth on the way to the hospital in the neighboring district of Achham. She had been referred to Bayalpata Hospital in Achham as the Bajura District Hospital didn’t have a doctor to provide emergency parturition service.

Earlier, Nani Rokaya of Bamu of Himali Rural Municipality-1, Bajura, had also given birth on the way to Bamu Basic Health Service Centre, just three hours away from her home. 

The stories of these women echo the predicament faced by many women living in remote corners of Nepal. Despite the promises laid out by the Right to Safe Motherhood and Reproductive Health Act, 2018, the ground reality paints a different picture. Women find themselves compelled to bring life into the world without the presence of healthcare professionals. 

The Nepal Demographic Health Survey (NDHS) 2022 reveals that while 94 percent of women receive antenatal care, the disparities in education and wealth play a pivotal role in determining access to essential services.

For most women living in remote parts of Nepal, the journey of childbirth becomes a perilous venture as the statistics on place of birth demonstrate a concerning trend. The NDHS survey reveals that women with no education (67 percent) and those in the lowest wealth quintile (75 percent) are less likely to have at least four antenatal care visits than those with more than a secondary education and those in the highest wealth quintile (93 percent each). Deliveries at a health facility are least common among Muslim women (67 percent) and most common among Brahmin/Chhetri women (87 percent) as per the health report. 

For survival and well-being 

Health care services during pregnancy and childbirth and after delivery are important for the survival and well-being of both the mother and the newborn. Antenatal care (ANC) can reduce health risks for mothers and newborns through monitoring of pregnancies and screening for complications. 

“Delivery at a health facility, with a skilled human resource reduces the risk of complications and infections during labor and delivery. It helps prevent postpartum hemorrhage,” says Dr Manor Din Shaiyed, senior obstetrics and gynecologist at Manmohan Memorial Medical College and Teaching Hospital, Swoyambhu. 

Timely postnatal care offers an opportunity to treat complications arising from delivery, provide intensive care for the newborn, and teach the mothers how to care for themselves and their newborns. 

Trends in place of birth

Year Delivered at home Delivered in health facility

1996 91 8

2001 88 10

2006 78 20

2011 54 44

2016 35 64

2022 19 79

Percent of live births in the two years before the survey

(Source: Nepal Demographic Health Survey 2022)

The proportion of health facility deliveries is lowest in Madhesh Province (67 percent), followed by Karnali Province (72 percent). The proportion is highest in Bagmati Province and Gandaki Province (88 percent each), followed by Sudurpashchim Province (87 percent).  Institutional delivery helps in preventing neonatal and child mortality. Neonatal mortality as a percentage of under-5 mortality has increased sharply in the country. With the lack of the health facilities in the country the share of neonatal deaths has increased from 64 percent of infant deaths in 1996 to 75 percent in 2022, as per the NDHS report. 

The neonatal mortality rate, infant mortality rate, and under-five mortality rate are 21, 28, and 33 deaths per 1,000 live births, respectively. Childhood mortality is highest in Sudurpashchim Province (neonatal, infant, and under-five mortality rates of 27, 40, and 49 deaths per 1,000 live births, respectively).

Lack of institutional services gives rise to maternal deaths.The World Health Organization reveals that almost 95 percent of all maternal deaths occurred in low and lower middle-income countries in 2020 and most could have been prevented. Care by skilled health professionals before, during and after childbirth can save the lives of women and newborns.

Maternal mortality

Women die as a result of complications during and following pregnancy and childbirth. Most of these complications develop during pregnancy and most are preventable or treatable. The major complications that account for nearly 75 percent of all maternal deaths are—severe bleeding (mostly bleeding after childbirth), infections (usually after childbirth), high blood pressure during pregnancy (pre-eclampsia and eclampsia), and complications from delivery. With a maternal mortality rate of 239, one out of every 167 women aged between 15 and 49 years in Nepal, could die unnecessarily from complications in pregnancy or childbirth, states Family Welfare Division.

 The leading causes of reported maternal deaths from 28 hospitals during a four-year period (2015–18) were eclampsia (19 percent) and postpartum hemorrhage (17 percent). Most maternal deaths occur within 48 hours of delivery (42.7 percent) and then in the late postpartum period (from 48 hours after birth to up to six weeks after childbirth).  Severe bleeding after birth can kill a healthy woman within hours if she is unattended. Injecting oxytocics immediately after childbirth effectively reduces the risk of bleeding. That’s why every pregnancy should be delivered in the health facilities, added Dr Shaiyed. 

The Ministry of Health and Population in collaboration with the National Statistics Office had collected data on live births and deaths of women of reproductive age (WRA) in the enumerated households for the last 12 months preceding the National Population and Housing Census 2021. Of the 653 pregnancy-related deaths, 611 maternal deaths were analyzed further for causes and attributes the study showed that many maternal deaths in Nepal are due to preventable causes such as hemorrhage and high blood pressure during pregnancy.  

According to the report published by the Nepal government, around 17 percent of women had died either while traveling from their residences to the health facilities or between the facilities. 

How can women’s lives be saved?

Nepal has committed to reducing its maternal mortality rate from 281 per 100,000 live births in 2006 to 116 by 2022, 99 by 2025, and 70 by 2030.  The country has already missed its 2020 target to reduce maternal mortality to 125 per 100,000 births. 

“If the government really wants to achieve the goal then it’s vital to make easy availability of delivery services in health facilities,” says Dr Shaiyed.

As per the Family Welfare Division under the Department of Health Services 1,100 women die because of complications related to pregnancy each year.  Access to high quality care in pregnancy, and during and after childbirth is important. It is important that all births are attended by skilled health professionals, as timely management and treatment can make the difference between life and death for the women as well as for the newborn, he adds.

Programs for safe motherhood

The government has its Aama and the Newborn Program where transport incentive is given to women immediately following institutional delivery: Rs 1,500 in mountains, Rs 1,000 in hills and Rs 500 in Tarai districts to encourage women to deliver in health institutions. Likewise, the President Women Upliftment Programme (PWUP) was launched on 8 March 2017 as a flagship program to meaningfully transform the life of disadvantaged, poor and marginalized women.  Women with long labor pain, those whose babies have died inside the womb, excessive body swelling during pregnancy, excessive bleeding after delivery, anemic pregnancy and those who have not been able to get treated in the local health centers are rescued by air under this program. 

The government provided free air service to 304 pregnant and postpartum women till January 2022.  In the fiscal year, 2075/76, 26 pregnant women were airlifted, 87 in the fiscal year 2076/77 and 103 pregnant women were airlifted in the fiscal year 2077/78.  Though the government has been trying to increase the hospital based deliveries it must increase the human resources, provide proper counseling to pregnant women, establish birthing centers, increase skill birth attendants if it really wants to increase the institutional based delivery and decline maternal mortality rate and neonatal deaths in the country.