Januka Biwakarma of Taplejung is preparing for her second baby. The first time she was pregnant, she had not even entered a hospital because she was too shy. But this time she has already had seven check-ups at the local hospital. There is a sense of awareness among women about maternity health care in the villages. "My daughter-in-law gave birth to her child at home, but now the women are conscious of their health and run to the hospital," says Pabitra Majhi of Pachthar.

This change has come about because of the government's program to decrease maternal mortality. The country was even awarded for its exemplary work with a MDG award in September. Nepal is now near achieving the target of decreasing the maternal mortality ratio (MMR) by three quarters (134/100,000) by 2015. In 1991, this number was at 517 in Nepal, had increased to 539 in 1996 but was brought down to 281 in 2006.

It is hoped that the programs and campaigns running at present will continue to have a positive impact. In pre and post natal care, a pregnant woman is supposed to get health check-ups in her fourth, eighth and ninth month and receive two TT vaccines. Fourth month onwards, she needs to take iron tablets and de-worming medicines. If a woman comes to a health centre for delivery with proof of having received all of this, she receives an allowance of Rs 400. Government hospitals, primary health care centres and health care centres offer free checkups to pregnant women and also give allowances: Rs 1500 in mountainous districts, Rs 1000 in hilly districts and Rs 500 in Tarai districts.

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