title: Utilization of maternal and child health services in western rural Nepal: a cross-sectional community-based study.
abstract: BACKGROUND
  Considering the commitment and investment of Nepal to reduce maternal and child mortality, understanding service utilization and factors associated with a child and maternal health services is important.
  
  
  OBJECTIVE
  This study was examined the factors associated with utilization of maternal and child health services in Kapilvastu District of Nepal.
  
  
  METHODS
  A cross-sectional study was conducted in 2010 by interviewing 190 mothers having children of aged 12-23 months using the standardized questionnaire.
  
  
  RESULTS
  Immunization status (97.4%) and vitamin A supplementation (98.4%) was high. However, initiation of breastfeeding within an hour of birth was low (45.3%) and 63.2% had practiced exclusive breastfeeding. Majority (69.5%) of respondents delivered their child at home and 39.5% sought assistance from health workers. The mothers who did not have any education, mothers from Dalit/Janjati and the Terai origin were less likely to deliver at the health facility and to seek the assistance of health workers during childbirth.
  
  
  CONCLUSIONS
  The immunization program coverage was high, whereas maternal health service utilization remained poor. Interventions that focus on mothers from Dalit/Janjati group and with lower education are likely to increase utilization of maternal health services.
authors.forename: Vishnu
authors.initials: V
authors.lastname: Khanal
authors.affiliation: MPH Candidate, Institute of Medicine, Kathmandu, Nepal.
authors.forename: Ramjee
authors.initials: R
authors.lastname: Bhandari
authors.forename: Mandira
authors.initials: M
authors.lastname: Adhikari
authors.forename: Rajendra
authors.initials: R
authors.lastname: Karkee
authors.forename: Chandni
authors.initials: C
authors.lastname: Joshi
mesh_terms: D001942:Breast Feeding / Q000706:statistics & numerical data; D002662:Child Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data; D007223:Infant; D008297:Male; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D009390:Nepal / Q000453:epidemiology; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014801:Vitamin A / Q000008:administration & dosage
chemical_list: D014801:Vitamin A