A scoping review of interventions to improve maternal and neonatal care in Nepal

Abstract

Background: Nepal has achieved significant progress in maternal health outcomes, and the country’s health system prioritises life-saving interventions during pregnancy, delivery, neonatal, and postpartum care. This scoping review aimed to systematically identify and analyse the available on interventions to improve maternal and neonatal care in Nepal. Methods: Our scoping review was conducted using Arksey and O’Malley’s five-stage framework to map existing interventions. Data searches were carried out in Medline, CINAHL, PsycINFO and Scopus, focusing on interventions to improve the maternal and neonatal care. Titles and abstracts were screened, followed by full-text reviews of potentially relevant studies. Key findings were retrieved using a data extraction sheet, and the findings were presented in a narrative synthesis. Results: Our review found 418 studies, and 20 (published between 2004 and 2023) were included for this scoping review using various interventions targeting maternal and neonatal populations. Five overarching interventions were identified. Community-based maternal health literacy was the most significant intervention, followed by health facility strengthening, including health staff training, mobilisation of female community health volunteers for birth preparedness and identifying danger signs, mobile health messaging, and involving husbands in improving the uptake of maternal and neonatal care. Most interventions were a mixture of activities with a combination of interventions rather than a single intervention. Conclusions: The findings highlight that no single intervention is sufficient on its own; indeed, a combination of approaches is needed to improve the uptake of maternal and neonatal care services. Effective interventions should be scaled up and extended to underserved and marginalised communities to ensure that maternal and neonatal care services are accessible to all.