By the beginning of 2020, Nepal had reached a tipping point with over 60% of births occurring in a health facility—a three times increase from just 18% in 2006.
National lockdown happened very early in Nepal, on March 21, 2020, well before any community spread of COVID-19. The lockdown took the form of severe restrictions on transport and closure of outpatient departments of many hospitals.
In this article, the authors compare intrapartum care before and during the lockdown period in Nepal. The number of institutional births decreased by 52·4% during the first 2 months of lockdown, and women in relatively disadvantaged ethnic groups were found to be affected more than those in more advantaged groups, indicating a widening equity gap due to COVID-19. They also found that quality of care in the hospitals was compromised compared with before lockdown.