Barriers in utilization of maternal and child health services among Musahar in Dudhauli Municipality of Sindhuli district, Nepal

Abstract

Background: Maternal and Child Health remains a public health challenge in Nepal. This study explored information regarding barriers in the utilization of Maternal and Child Health services among women of Musahar community.Methods: A cross-sectional study was carried out in Dudhauli Municipality, Sindhuli using qualitative and quantitative methods. Qualitative data were obtained from, In Depth Interview among health workers and a Focus Group Discussion among FCHVs of Musahar community. Interview was carried out using questionnaire for quantitative study among 121 mothers of under 5 children. The data was analyzed using SPSS software version 21. Chi Square test was applied to test the associations while p value <0.05 was considered significant.Results: The average age and age at marriage of respondents were 24.6±5.7 years and 16.22±2.8 respectively, 76% were illiterate, 93.2% lies below poverty line and 73.6% were home maker. Among them, 29.8 did not have ANC while 47.1 had 4 or more ANC visits, 64.5% institutional delivery and 29.8% PNC visit. Social barriers and lack of information are major barriers contributing to more than half of no ANC visit and which contribute to >60% in case of PNC. Home delivery for first child was 56.2% while for last child was 33.9%. Almost 1/5th of the children were not vaccinated. Qualitative study identified social factors like negligence, family pressure, shyness, and unhealthy financial decisions as important barriers.Conclusions: Utilization of maternal and child health services was poor among Musahar mothers and children which indicates a serious public health concern.