Lack of timely purchase of 'magnesium sulphate' vital in the treatment of eclampsia which is the main cause of maternal death has resulted in dire shortage of this vital medicine.
Magnesium sulphate (MgSo4) is essential drug that is used to control for seizures associated with pre-eclampsia, eclampsia and a period of 42 days following the delivery.
Health budget has been already allocated to the local level and lack of timely purchase of such essential injectable drug including oxytocin which is used to intervene with excessive bleeding in new mothers have caused problem to deal with such cases, according to Family Health Division safe motherhood program's community nursing officer Keshu Kafle. Their stocks also have been used, she added.
These medicines are needed to be in every health institutions. If a pregnant needs to be referred to another health facility for delivery, she must be injected with a first dose of mgSO4 which is relatively very affordable drug.
Similarly, if a pregnant develops seizures before and during delivery and a new mother till 42 days of delivery, she must be given this drug for control of seizures. Lack of timely intervention in such cases may lead to the death of a patient due to breathing difficulties.
Despite the investment of millions of rupees by the government to control maternal death in Nepal, expected results are still awaited. The Nepal Population and Health Survey Report-2016 shows that the maternal mortality rate in the past seven years is 239 in every 100,000 live births. Before this report, this figure was 258. Maternal death is medically defined as the death of a woman from health complications during pregnancy, at time of delivery or within 42 days of pregnancy.
The Survey shows the current death related to pregnancy is 239 per 100,000 live births. The same was 281 as per the 2006 Survey while it was 543 as per the 1996 Survey.
Community nursing officer Keshu Kafle sees the need of making additional analysis as to why the maternal mortality rate has not decreased and the local level have the main responsibility now for reducing the maternal mortality rate.
"It is their (the local level's) responsibility to allocate the budget in time for purchasing the medicines that is vital for checking maternal mortality rate. Many complaints have been received of several health institutions running out of stock of this medicine and not getting adequate money for buying it," she said and drew the attention of the chiefs of the local levels towards this problem.
Kafle expressed concern that the maternal mortality rate could go up if there was further delay in procuring this vital medicine.
There are 1,800 birthing centers with trained birth attendants and more than 8,000 trained birth attendants for safe delivery.
Every health post has been themselves procuring this medicine. Before this, the health institutions used to purchase the medicine under the Safe Motherhood Program through the District Public Health Office. The problem has been seen at present as the budget for this purpose is not available. As per the new provision, the budget for this purpose comes through the local levels.
The health facilities with less than 25 beds have been getting Rs 1,000 for providing a normal single delivery service and they have been purchasing the medicine with this money at present.
However, the local levels have not provided this amount to the health facilities and hence the present problem, the Division said.
