Palpa has become the first district in Lumbini Province to have a fully institutionalized maternity service. Two municipalities and eight rural municipalities here have declared themselves as municipalities with fully institutionalized maternity services, said Tuk Prasad Pokharel, acting chief of the Health Office, Palpa. According to him, all the criteria have been met as per the Lumbini Province Government's Declaration and Assurance Criteria 2080, making the rate of home deliveries in the district zero. The Health Office has stated that it has made significant progress in safe maternity services in recent years and has succeeded in becoming a district with fully institutionalized maternity services. The Health Office has stated that its formal announcement will be made on Jestha 5. In the fiscal year 2074/75, the number of home deliveries in Palpa was 754. This number is gradually decreasing due to the campaign to have deliveries in health institutions, public awareness, the activism of women's health volunteers, and local level coordination.

It had decreased to 394 in 2075/76, 243 in 2076/77, 203 in 2077/78, 119 in 2078/79, and a total of 28 in 2079/80. He said that the district was declared a district with full institutional maternity services as the number of home deliveries reached zero in the financial year 2081/82. 'There is a significant contribution from various parties behind this success,' said Acting Chief Pokharel, 'Safe maternity services have been provided in every village through health posts, birthing centers, and hospitals. That is why we have been able to provide full institutional deliveries.'

In the past, awareness programs on regular pregnancy check-ups, nutrition, safe childbirth and risks were conducted . The health department of the municipality has informed that women's health volunteers have been conducting door-to-door campaigns and encouraging pregnant women to give birth in health institutions. Mohan Dhakal, head of the Purbakhola Rural Municipality Health Department, said that free maternity services, transportation expenses and incentive allowances under the Safe Motherhood Program have also attracted women towards institutional delivery.

He said that Purbakhola Rural Municipality declared itself a municipality with full institutional maternity services for the first time in 2076 BS. Only after that have other municipalities also tried to make it a fully institutional municipality. As a result, Tinau, Nisdi Rural Municipality and Rampur Municipality were successful in declaring it last year, according to the health office.

The local level has initiated the establishment of birthing centers, green flags, egg distribution, additional transportation expenses, reaching out to women's representatives to understand their health status and provide nutritional allowances, opening accounts in the names of the child and mother, and providing expenses if referred elsewhere.   District Coordination Committee Chief Tankanath Khanal said that it was also successful because of the formation of monitoring teams, monitoring by health workers, and community women volunteers.   

He said that the collaboration between the local government, health workers, social organizations, and the community has helped reduce maternal and infant mortality rates in Palpa. 'This campaign has not only improved maternity services but also increased society's awareness of women's health,' he said, 'therefore, this achievement has become an inspiring example for other districts as well.' 

According to the data of 12 districts of Lumbini Province, in 2081/82, there were 177 home deliveries in Kapilvastu, 54 in Banke, 41 in Pyuthan, 25 in Dang, 19 in Bardiya, 13 in Rolpa and 31 in Rukum East. Gulmi has made significant improvements and reduced the number of home deliveries to 3. Palpa is the first to achieve this as Gulmi could not reach absolute zero. Although Rupandehi and Nawalparasi West achieved near-zero status last year, Palpa has achieved the full achievement first.

According to the National Census 2078, Lumbini had the highest maternal mortality rate among the seven provinces. The main reason for this is considered to be the prevalence of home deliveries. Therefore, after the institutional delivery campaign, maternal and newborn mortality rates have been decreasing.

In geographically remote Nisdi Rural Municipality of Palpa, eight years ago, 221 women gave birth at home, while only one gave birth at a health facility. But in the previous fiscal year, not a single woman gave birth at home, said Health Branch Chief Rem Bahadur Disha Magar. In Tinau Rural Municipality, located along the Siddhartha Highway, where transportation is easily accessible, only three women gave birth at a health facility eight years ago, while 103 women gave birth at a health facility. But now, all of them have given birth at a health facility.

The number of home deliveries in two municipalities and all eight rural municipalities of Palpa has been zero since the previous fiscal year. Rampur Municipality Mayor Raman Bahadur Thapa said that investment in the health sector has increased in recent years, and the role of health workers and community women's health volunteers is also important. In the past, due to geographical remoteness, lack of awareness, lack of access to health institutions, and lack of regular ambulance services and vehicles, home births were common.

According to the latest census, 151 deaths were recorded per lakh pregnant and postpartum mothers across the country. Lumbini Province recorded 27 deaths per lakh. Which is the highest among the seven provinces.