Sheetal Sharma: Mixed–methods evaluation of maternity care intervention in rural Nepal

Sheetal Sharma interviewing women in Nepal as part of her PhD research into access to and understanding of maternity-care and reproductive healthcare in the country.

Researcher: Sheetal Sharma

The Nepal based-research looks to better understand the constraints of care-seeking behaviour in maternal health. Too often women in developing countries do not have ‘rights’ over their own body: ‘when to get pregnant; how often and when to access health services.’ To this end, in 1997 Green Tara Trust (GTT), a Buddhist charity, focused on the (basic) human rights issue of women’s reproductive and maternal health in Nepal (www.greentaratrust.com); working alongside Bournemouth University they are working to increase provision, access to health and maternity care and education of Nepalese women in reproductive health.

Research constitutes an important component of Green Tara Trust’s activities.  A study associated with the Trust found that a major barrier to accessing maternal health services in rural Nepal was the lack of support from        mothers-in-law. The latter were the main decision-makers and controlled the money in the household. Thus in 2007, a community intervention (5 years) was implemented with community groups (including men, mothers and their daughters-in-law) to reduce these social and familial barriers and improve the uptake of maternal care in rural Nepal via health promotion. My collaboration with GTT began as a Research Assistant and grew into a PhD at Bournemouth University evaluating this intervention.

Nepal has been in transition since 1990, from an authoritarian Hindu kingdom to a constitutional monarchy and now a republic. The decade-long civil war (1996-2006) also stalled progress in health indicators in Nepal.           Currently, the country is divided not only geographically but also by caste, ethnicity, religion and a federal system. Minorities, lower-caste people and rural residents have been historically marginalized. Nepal is the 22nd poorest country in the world with 25.2% of people earning less than the US$1.25 per day poverty line. Despite these odds it has performed well in certain health outcomes, such as a reduction in maternal mortality to 170/100,000. Now that the conflict is over, it is imperative that research, like Green Tara Trust, continues to improve health and services for its largely rural communities and that social policy in Nepal can be shaped to be ‘inclusive’ of those marginalised.

This research has successfully been presented at international conferences (Society for Social Medicine (London); University of Berkeley (USA); Nepal’s National Health Promotion Conference (Kathmandu); 2012 Spanish Stata Users Group meeting and the European Congress on Tropical Medicine & International Health (Denmark).

Sheetal Sharma’s PhD research is supervised by Bournemouth University’s School of Health and Social Care and Centre for Midwifery, Maternal and Perinatal Health, Professor Edwin van Teijlingen, Professor Vanora Hundley and Dr. Catherine Angell ;IsGlobal’s Dr. Elisa Sicuri; University of Sheffield’s Dr. P. Simkhada and IECS Argentina’s          Professor Jose Belizan and carried out with funding from Santander Universities and Bournemouth University.

 

Sheetal also talked to the public about her work in Nepal here.