Tropical Doctor > Volume 38, Number 4 > Pp. 197-201

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Addressing the attitudes of service providers: increasing access to professional midwifery care in Nepal

S Clapham MSc   ^*    D Pokharel MA      C Bird MSc      I Basnett MD MPH   

^* Health Adviser, DFID Nepal, PO Box 106; Chief of Programme Communications, UNICEF-Nepal, UN House, GPO Box 1189; Communications Adviser, SSMP-Nepal, Department of Health Services, GPO 7830; Country Director, TCIC/Ipas, GPO 7830, Kathmandu, Nepal

Correspondence to: S Clapham, Health Adviser, DFID Nepal, PO Box 106, Kathmandu, Nepal Email: s-clapham{at}dfid.gov.uk

Increasing access to professional care during labour and delivery is the central strategy in Nepal's commitment to reducing its maternal mortality ratio. This paper outlines a number of complementary interventions used by the Nepal Safer Motherhood Project to address the negative attitudes prevalent among service providers, which is a contributing factor to the under-utilization of the health-care services. The perspectives of the community and the service providers are presented, with a discussion of the importance of effective communication, the establishment of positive relationships and a demonstration of the critical role of local ownership and involvement in bringing about a positive change.

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