title: Addressing the attitudes of service providers: increasing access to professional midwifery care in Nepal.
abstract: Increasing access to professional care during labour and delivery is the central strategy in Nepal's commitment to reducing its maternal mortality ratio. This paper outlines a number of complementary interventions used by the Nepal Safer Motherhood Project to address the negative attitudes prevalent among service providers, which is a contributing factor to the under-utilization of the health-care services. The perspectives of the community and the service providers are presented, with a discussion of the importance of effective communication, the establishment of positive relationships and a demonstration of the critical role of local ownership and involvement in bringing about a positive change.
authors.affiliation: Health Adviser, DFID Nepal, PO Box 106, Kathmandu, Nepal. s-clapham@dfid.gov.uk
authors.forename: S
authors.initials: S
authors.lastname: Clapham
authors.forename: D
authors.initials: D
authors.lastname: Pokharel
authors.forename: C
authors.initials: C
authors.lastname: Bird
authors.forename: I
authors.initials: I
authors.lastname: Basnett
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D017053:Infection Control; D008880:Midwifery; D009390:Nepal; D011787:Quality of Health Care