Maternal and Child Health in Nepal: The Effects of Caste, Ethnicity, and Regional Identity Further Analysis of the 2011 Nepal Demographic and Health Survey

Kathmandu, Nepal March 2013

Maternal and Child Health in Nepal: The Effects of Caste, Ethnicity, and Regional Identity Further Analysis of the 2011 Nepal Demographic and Health Survey

Jhabindra Prasad Pandey1 Megha Raj Dhakal, PhD2 Sujan Karki3 Pradeep Poudel4 Meeta Sainju Pradhan4

1

Family Health Division, Ministry of Health and Population

2

Population, Education, and Health Research Centre

3

Nepal Family Health Program II

4

Nepal Health Sector Support Program

Kathmandu, Nepal March 2013

This report presents findings from a further analysis study undertaken as part of the follow-up to the 2011 Nepal Demographic and Health Survey (NDHS). Funding for the further analysis of the survey was provided by the United States Agency for International Development (USAID), the United Kingdom’s Department for International Development (DFID) and the United Nations Population Fund (UNFPA). ICF International provided technical assistance for the survey and further analysis, and New ERA provided in-country coordination and technical assistance through the MEASURE DHS program, a USAID-funded project providing support and technical assistance in the implementation of population and health surveys in countries worldwide. The opinions expressed herein are those of the authors and do not necessarily reflect the views of USAID or the US government or other funding agencies. This report is part of the MEASURE DHS program, which is designed to collect, analyze, and disseminate data on fertility, family planning, maternal and child health, nutrition, and HIV/AIDS. Additional information about the 2011 NDHS may be obtained from the Population Division, Ministry of Health and Population, Government of Nepal, Ramshahpath, Kathmandu, Nepal; telephone: (977-1) 4262987; and from New ERA, P.O. Box 722, Kathmandu, Nepal; telephone: (977-1) 4423176/4413603; fax: (977-1) 4419562; e-mail: [email protected] Information about the DHS program may be obtained from MEASURE DHS, ICF International, 11785 Beltsville Drive, Suite 300, Calverton, MD 20705, USA; telephone: 301-572-0200; fax: 301-572-0999; e-mail: [email protected]; Internet: http://www.measuredhs.com.

Recommended citation: Pandey, J. P., M.R. Dhakal, S. Karki, P. Poudel, and M.S. Pradhan. 2013. Maternal and Child Health in Nepal: The Effects of Caste, Ethnicity, and Regional Identity: Further analysis of the 2011 Nepal Demographic and Health Survey. Calverton, Maryland, USA: Nepal Ministry of Health and Population, New ERA, and ICF International.

CONTENTS CONTENTS ........................................................................................................................................................... i TABLES ............................................................................................................................................................... iii FIGURES ............................................................................................................................................................. iii FOREWORD ........................................................................................................................................................ v ACKNOWLEDGMENTS .................................................................................................................................. vii ABBREVIATION AND ACRONYMS ............................................................................................................ viii 1

BACKGROUND AND RATIONALE ................................................................................................... 1

2

SOCIAL DISPARITIES IN ACCESS TO AND UTILIZATION OF HEALTH SERVICES .......... 3 2.1