Similarly, maternal mortality rate has gone down to 229, which means that we are well on track to achieve the target of reducing it to 213 by 2015. This is still a far cry from what the developed countries have achieved in the area of maternal and child mortality rates, but we have to measure our achievements against our past records. Till 1990, our maternal mortality rate was 850 and infant mortality rate was 160. The fact that we have been able to come this far during the last two decades is indeed a remarkable feat.
Akin to the saying that “Rome was not built in a day”, this success was not achieved overnight, and definitely not without sustained and concerted efforts. Killing people is easy, saving lives is not. In a society where poverty is pervasive, where roughly one in every two citizens cannot read and write, and where superstition still grips community after community, achieving health targets is much difficult than it appears. Nepal´s achievement in reducing maternal and child mortality rates has been made possible only by persistent work of different stakeholders. Without commitments of the successive governments and continued support – financial and technical – from the donors, this target would have been difficult to meet. But without the relentless work of over 53,000 female health volunteers, spread across the country, achieving it would have been impossible.
These women with modest family background, and perhaps with little education and even less material possessions, are the true unsung heroes behind this rare success story coming out of this country. The volunteers are paid just a meager daily allowance for the day they are asked to work. If it was not for their personal commitment to volunteerism, they would not have risked their lives during the decade-long conflict and continued their work unhindered in the hinterlands of the country. With more training and support from the state, these volunteers can become effective foot soldiers for social mobilization.
Gender is a huge issue in Nepali society as women lag behind men in almost every sphere of life – compared to men, women literacy is low, and so is their average life expectancy. Generally, women participation in family decision-making is low, and almost non-existent in many families. The only way to change this imbalance is to give women more space and opportunities. As the female health volunteers have amply demonstrated, women will grab every available opportunity and change things for the better if they are get a chance to do so.
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