Puerperal Sepsis in Rural Nepal: A One-Year Retrospective Study (2023–2024) and Strategies for Mortality Reduction

Background: Puerperal sepsis is a leading cause of maternal morbidity and mortality in Nepal’s rural districts. Timely intervention and preventive strategies are essential to reduce preventable deaths.  Objective: To assess the prevalence, clinical features, and contributing factors of puerperal sepsis in rural areas of Nepal, and to propose mortality-reducing interventions.  Methods: A retrospective record review was conducted across three rural hospitals in Dolpa, Humla, and Bajura districts from June 2023 to May 2024. Data on postpartum women diagnosed with puerperal sepsis were collected and analyzed.  Results: Among 642 deliveries, 48 (7.5%) developed puerperal sepsis. Eight maternal deaths occurred, yielding a case fatality rate of 16.7%. Risk factors included home delivery (62.5%), delayed care-seeking, and poor hygiene.  Conclusion: Puerperal sepsis in rural Nepal is a significant but preventable cause of maternal mortality. Community education, improved hygiene, and health system strengthening are key strategies.