In Nepal, more than half (50.3 %) of the total population are women, 52.3% of whom are of reproductive age. Given the current fertility rate of 4.1, the Ministry of Health and Population projected that the number of births for 2006 would be about 900,000. The armed conflict has also had a direct impact on the lives of children and women in Nepal. Family structure are shaken when households are increasingly headed by women due to increased migration; when the whole or parts of the family have become displaced; and when children move alone or with family members to urban areas or to India seeking security, work and education.
Maternal deaths are the tip of the iceberg when it comes to poor maternal health. Maternal deaths are defined as any death that occurs during pregnancy, childbirth, or within two months after the birth or termination of pregnancy. Over 585 thousand maternal deaths are estimated to occur each year. Pregnancy-related complications account for 18.5% of the global burden of disease among those of reproductive age. The burden of reproductive ill health is especially high for women in sub-Saharan Africa. Globally each year it is estimated more than 4 million newborns die within the first days or weeks of life. Globally each year an estimated eight million babies are still-born or die in the first month of life and, almost all (98%) of these deaths occur in developing countries. Altogether 10.6 million children a year die before their fifth birthday. Almost all deaths as a result of pregnancy and childbirth are avoidable. 99% occur in developing countries and two thirds of these in just 13 countries.
Maternal mortality in Nepal is high, which is one of the most important indicators of maternal health. There is a variety of figures. The latest estimate of the maternal mortality in Nepal is 539 deaths per 100,000 live births. Every 2 hours one woman dies because of complications related with pregnancy and delivery. The UNFPA has ranked Nepal as the worst affected country in south Asia. The direct and leading causes of maternal mortality in Nepal are postpartum hemorrhage, eclampsia, infection, obstructed labor, and complication of abortions. It is estimated that over 32,000 children die each year in Nepal during their first month of life, with over two-thirds of these dying during their first week. Nearly the same numbers are still-born. Children living in the mountains fare much worse than those living in the hills or terai.
