The scene of giving birth on the pavement showed the report card of the health system: Dr. Karki
Kathmandu. Tosima Karki, a lawmaker of the Rastriya Swatantra Party, has said that the incident of a woman giving birth on the roadside near Gajendra Narayan Singh Hospital in Saptari has raised serious questions about the maternity service and the overall health system of Nepal.
Speaking at the meeting of the House of Representatives on Friday, Karki said although she was proud of the free institutional maternity service, the implementation of the maternity protection programme and the decreasing maternal mortality rate, there was a big problem in the health services available to the citizens in practice.
She said, “We take pride in the fact that in Nepal, institutional delivery is free, there is a maternity protection program, and the maternal mortality rate is decreasing. Even transportation incentive expenses are given. But the scene of a mother giving birth on the roadside near Gajendra Narayan Singh Hospital, that too a federal government hospital, has brought us a report card of our maternity service and the entire health system. “
The constitution guarantees the right to health, safe motherhood and reproductive health, but there is a huge gap between the free service written on paper and the services that the citizens get in practice,” she said.
She said that triage and emergency clinical assessment should be started immediately for women who reach the hospital in labor pain, and maternal fetal evaluation should also be done immediately. She said that women who reach the hospital in labor pain should be admitted immediately and kept under constant monitoring.
She questioned the serious negligence of not searching for the patient admitted to the hospital and not contacting the family when she was out of contact.
Karki said that it should be the responsibility of the hospital to safely admit the woman who reaches the hospital for delivery, transport her if needed, and monitor her regularly. She said that if the patient is not found on the bed, they should be searched and contacted immediately through the phone number placed on the form.
She said that even when there is no money for blood tests, the social service unit and the Mother Protection Program should be activated immediately. She said that the Mother Protection Program should not be limited to the process of childbirth.
Stating that the Ministry of Health has initiated an investigation into the incident and a team from the Nepal Medical Council has also reached there, Karki said that the investigation should not be limited to identifying the guilty and taking action. He stressed that measures should also be taken to prevent such incidents from happening again in the future. She also demanded that the Mother Protection Program should be organized as a ‘Complete Maternal Package’. She said that the program should include services ranging from maternity and child services to necessary check-ups, medicines, treatment, video X-ray, maternity services and family planning. She said that some hospitals do not provide medicines free of cost and charge for video X-ray and other services, adding that the programme would not be effective in such a situation. She also demanded that the social service unit in every hospital be activated 24 hours a day. He said that the hospitals themselves should develop a system to identify the economically weak patients and provide necessary support by ending the situation of poor patients raising money on their own and seeking help. Karki also demanded that there should be a detailed ‘Maternal Care Audit’ in every hospital, regular regulation and necessary action should be taken.
She said that not only the data of how many patients came, how many gave births and how many surgeries were carried out, but also the time when the patient came to the hospital, whether triage was done or not and how the treatment process proceeded should be included in the record and evaluation.
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