Sabi survived a premature birth - now she's focused on future generations in Nepal

CQUniversity researcher Dr Sabi Kaphle has quite literally had a life-long investment in improving the survival of women and babies in remote villages of Nepal.

Sabi was born premature and her mum experienced serious complications during her pregnancy' so she considers herself lucky to have survived without access to quality healthcare services at that time in Nepal.

"After listening to the story of my own birth' I trained as a midwife and worked in remote mountain villages of Nepal to make sure that women have access to information' resources' support and services during pregnancy and childbirth'" Sabi says.

"Despite my attempts to ensure access to trained midwives in villages' many women and babies were still dying.

"I couldn't stop these deaths happening and' being curious' I completed a PhD exploring the socio-cultural factors influencing pregnancy and childbirth experiences of women in remote mountain areas of Nepal."

Sabi realised she could not overcome challenges such as travel distances and transport issues impacting pregnancy and birth outcomes in the mountainous nation' so she has focused on the role of influencing policy and practice in enabling access to appropriate health services.

The CQUni academic recently presented at the International Qualitative Health Research Conference in Vancouver' Canada' which was attended by around 200 delegates.

Sabi's paper highlights the issues of remoteness' food insecurity and gendered social practice being the critical challenges to promote maternal and newborn survival.

Women in her areas of research have high rates of illiteracy' poverty' disadvantage' and maternal and newborn mortality' and low life-expectancy.

"These women hold strongly to cultural tradition and spiritual belief systems' created and perpetuated within their social structure' which informs perceptions of and decisions for safety and risk during pregnancy and childbirth'" Sabi says.

"While women and their families value traditional knowledge more than medical knowledge' they will not seek medical care."

Sabi's findings suggest addressing the social' cultural and structural barriers that are limiting women's access to care during pregnancy and childbirth in remote settings.

She urges a policy shift from the medically-centred healthcare approach to a context-specific social approach to maternal and newborn health in Nepal and similar settings globally.

"Giving voice to the people who are voiceless' aiming to provide access to those who have been marginalised and speaking with the evidence to influence policy and practice has been part of my ethos now. I am keen to bring those insights to the discussion' so that we can promote maternal' newborn' child and adolescent health outcomes globally."

Sabi's presentation - Beyond the Hospital and Medical Care: Understanding the Critical Determinants of Maternal and Newborn Health Outcomes for Women living in Remote Mountain Villages in Nepal - generated critical dialogue around maternal and newborn survival in low-resource and remote settings globally. The conference was organised by International Institute of Qualitative Methodology in Canada.