Unpacking equity trends and gaps in Nepal’s progress on maternal health service utilization: Insights from the most recent Demographic and Health Surveys (2011, 2016 and 2022)

Marginalized women experience lower uptake of routine maternity care visits and higher discontinuation along the antenatal through to ponstantal period, creating significant equity gaps in Nepal. The increasing trend of deliveries in private HFs, particularly deliveries by elective CS without maternity incentives could lead to financial hardship while seeking routine maternal health care. Health systems should adopt targeted strategies addressing specific needs, considering intersecting marginalization factors. Key interventions include improving infrastructure, hiring and training local health workers, revising maternity incentives, regulating private HFs, and conducting quality audits, including increasing trends of CS deliveries.