Maternal health in eastern terai, nepal: still a challenge among the dalit mothers

Background: Maternal death and disability rates prevails the huge differentials that exist between mainstreamed and excluded groups across the country. The low level of Maternal-Child Health service utilization, lack of awareness and education, early age at marriage, and poor nutritional status and more affect the total well being of Dalit mothers. Objective of this is to assess the maternal health care practices and services utilized by the Dalit and Non-Dalit mothers in Eastern Terai, Nepal. Methods: A cross-sectional study was carried out with 720 Dalit and Non-Dalit mothers during July to December 2011. Direct interview was held by using interview schedule with the selected mothers in three districts of eastern Terai, Nepal. Mothers having at least one live birth 5 year preceding the survey were included. Results were analysed by using SPSS software version 16. Results: The socio-economic and demographic status of Dalit mothers was comparatively lower than the Non-Dalit mothers. Significant difference in the MCH care and service utilization is also observed. Dalit mothers made less Antenatal Care visits, less pregnancies were checked in health facilities and by health professionals (P<.001). Similar trend are also observed in the institutional delivery and delivery attendance by health professionals (P=<.001). Postnatal Care visits was less among the Dalit mothers (13.4 %) in compared to Non-Dalit (P<.001). Lack of awareness, lack of family support, poverty and lack of transportation facility were key barriers for the utilization of MCH services. Conclusions: Significant differences in MCH care and service utilization is observed between Dalit and Non-Dalit mothers; hence, a special focus has to be provided for the Dalits by the government as well as other concerned agencies.