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BackgroundAlthough there has been significant improvement in maternal and newborn health, Nepal needs further acceleration in improving access to and coverage of services to achieve Sustainable Development Goals by 2030. In this context, we aimed to analyze availability and readiness for Basic Emergency Obstetric and Neonatal Care (BEmONC) services in Nepal using data from Nepal Health Facility Survey (NHFS), 2021.MethodsWe analyzed nationally representative NHFS, 2021 data to determine availability and readiness of HFs for BEmONC services based on the “Service Availability and Readiness” manual of World Health Organizations. We performed weighted descriptive and inferential analysis to account complex survey design of NHFS 2021. We summarized continuous variables with mean, standard deviation, median and interquartile range whereas categorical variables with percent and 95% confidence interval (CI). We applied simple, and multiple linear regression to determine factors associated with readiness of HFs for BEmONC services.ResultsThe proportion of facilities with all BEmONC signal function available was 2.49% at the national level with Madhesh having the highest (5.22%) while Gandaki having the lowest (1.22%) availability. BEmONC service availability was relatively lower in rural setting and peripheral facilities. The overall readiness score for BEmONC services is 54.14, with domains of guidelines/staff, equipment/supplies, and medicines/commodities having scores of 21.16, 76.76, and 64.50 respectively. In multivariable analysis, level of facilities, province, urban rural setting, ecological belt, presence of external supervision, 24-hour duty schedule and number of beds were found to have statistically significant association with BEmONC service readiness.ConclusionThe readiness of HFs for BEmONC services in Nepal is relatively poor and can be improved by increasing service provision, expanding service hours to 24-hours a day, increasing availability of essential medicines and equipment, enhanced monitoring, and conducting periodic review of maternal and newborn deaths at HFs. |
