Panchthar is a hill district of the Mechi Zone in Nepal’s Eastern Development Region. The district covers 479 sq mi / 1,241 sq km. The district has a reported a population of 195,460, with 5,300 pregnancies per year. The rate of childbirth with a skilled birth attendant, the single most effective intervention to reduce maternal mortality, is less than 25%. Most facilities lack power, running water and are under-staffed. Estimates of maternal and neonatal mortality are twice the national average.