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By Paavan MATHEMA
Ramechhap (AFP) – As a teenager, Meera Nepali was terrified of going to work with her first child at home in a remote village, miles away. 39, a hospital. Nepali told AFP that she was working three days in the village of Khadadevi in the hilly district of Ramechhap in Nepal
. This year, however, she gave birth to her second child in a rural health center through a small financial incentive that allows pregnant women to go to the hospital by paying for their bus tickets .
The Aama Surakshya Program More than two million Nepalese women have access to medical services in the poor country where to die in childbirth remains a very real risk.
The United Nations Population Fund says childbirth remains a major killer of women of childbearing age in Nepal. in childbirth is higher than anywhere else in South Asia except in Afghanistan
The difficult terrain of the Himalayan nation constitutes a major obstacle to the security of deliveries, which often makes it difficult and long the journey to a health center, as well as the lack of clinics in many parts of the country. "We discovered that one of the main reasons why rural women did not go to the hospital during childbirth was that they had not had enough of it. money to pay for transportation, "said Suresh Tiwari, one of the architects of the project.
The program was launched in 2005 with money from British aid, but has since been taken over by the Nepalese government.
Today, it covers not only transportation but medical expenses for mothers and babies. check-ups.
The year 2017 marked a milestone in the program: more Nepalese women opted for hospital deliveries for home births for the first time, according to official figures.
very effective at getting women into health centers and hospitals where they can be saved in case of complications, "said Tara Nath Pokharel, head of the government's Family Health Division, who now runs the program . home & # 39;
Nepalese, one of the beneficiaries, did not pay anything for his three-day stay in a clinic in Ramechhap district, east of Kathmandu , in January.
She was fired with 1,000 rupees transport plus a bonus of 400 rupees to attend four prenatal appointments.
"I went home by ambulance, we just had to spend anything, I'm really thankful for this facility," said Nepali, cradling his young son in his arms.
The plan also saves lives outside maternity hospitals, partly by addressing cultural barriers.
Profoundly patriarchal attitudes and traditional preferences Sita Khatri went into labor several weeks before delivery and, unable to walk the three hours to the nearest health center, gave birth to a healthy boy at home.
But the 27-year-old child was suffering from placental retention, a painful and potentially fatal complication of childbirth, and had to plead with her husband to take her to the hospital. 39; hospital.
"He said we did not have money, I insisted, saying that there are government facilities, we will not have to spend too much," he said. Khatri.
"It's better to go to the hospital than to die at home."
Finally, Khatri's husband gave in. She was treated for free at a nearby clinic and the couple also received Rs.1000. to pay for the transport.
But some women can not be reached by road and must be transported, while others find themselves poorly equipped. Shakya, doctor in a health center in Ramechhap
"Some women still do not have the decision-making power to say that they want to go to the hospital, and health posts like ours are not equipped enough, "said Shakya.
Nepal has managed to reduce maternal mortality by 71 percent between 1990 and 2015 – simply missing an ambitious Millennium Development Goal to reduce the rate by three quarters.
But there is a long way to go to improve the overall quality of its health care, said Binjwala Shrestha, a chari "
" Reaching the hospital alone is not enough ", has she declared
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