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Celebration and Tragedy: Why Maternal Health Services in Remote Areas Need Strengthening

Case Study 2: Basanti Died Soon after Giving Birth

The importance of improving access to MNH services was brought home to the project team by a women dying in child birth in one of the project’s VDCs in January 2015. This was a tragic lesson for the project of a woman who was not reached.

A woman in the equity and access programme (EAP) area had married when she was only 14 years old. She had a difficult marriage as her husband often got drunk, her in-laws were not supportive and her first child died at four days old.

In 2014 the RAMP social mobiliser came to know that the now 18-year old woman was pregnant with her second child. She had not been participating in the RAMP MNH awareness raising meetings. The mobiliser went to her home in September 2014 and after a long discussion she admitted that she was six months pregnant. She was alone as her husband and in-laws were in Jhapa district on their personal work, a day’s bus ride away.

The woman said she had never visited a health facility for an ANC check-up and had never taken iron supplements. The mobiliser invited her to participate in the next mothers’ group meeting; but she did not come. She only attended after the mobiliser and local FCHV asked her again.

At her first meeting, the other members tried to convince her to go for an ANC check-up. She said she would, but did not. Neither did she go to the nearby primary health care outreach clinic for a check-up. The main reason for her not attending was the negligence of her husband and in-laws and the fact that the health facility was far away (2.5 hours walk away).

On 23 January 2015, nine months into her pregnancy, her labour pains started at 4 am. She delivered her baby at home the next day. She, however, had a retained placenta and due to heavy bleeding became unconscious. Even in that situation, her husband and mother-in-law did not try to take her to the health facility and instead called a traditional healer. After the woman had been unconscious for a long time, a neighbour went to the health post to call a health worker.

In the meantime the woman became conscious for a short while but soon after became unconscious again and died at 1 pm on 24 January 2015 leaving her baby daughter behind. We cannot imagine the pain and feelings of despair she must have felt.