Nepal has one of the highest rates of maternal deaths in Asia: currently 12 women die in Nepal every day either during pregnancy or childbirth. Nine out of 10 mothers deliver their babies at home without skilled birth attendants, contributing to a high level of maternal mortality
The DFID-funded Support to the Safe Motherhood Programme (SSMP) worked closely with the Government of Nepal from 2005-2010 to improve maternal and newborn health and survival, especially for the poor and excluded. SSMP followed and built on the Nepal Safer Motherhood Project which was implemented by Options from 1997-2004. SSMP supported the delivery of and access to quality maternal and newborn health services, including human resources, infrastructure investments, equipment and supplies and comprehensive abortion care.
SSMP also provided technical support to the Maternity Incentive Scheme which the government implemented to help mitigate the high financial cost of childbirth (transport, loss of earnings/support and medical costs) so that poor women, many of them in remote rural areas, can reach maternal clinics. Recent evidence suggests a solid decline in maternal mortality over the past 10 years, an impressive outcome for Nepal and for the commitment of those working over this period to improve access to high quality maternal and neo-natal care.
In collaboration with government and non-government stakeholders, SSMP has helped to achieve a number of milestones contributing to the achievement of the Millennium Development Goals:
- finalisation and approval of The National Safe Motherhood and Newborn Health Long Term Plan 2006-17.
- supported government policy development to incorporate global evidence in "key" documents including the Skilled Birth Attendant Policy, the National Blood Transfusion Policy and has led the development of the essential Maternal and Neonatal Health package and need assessment tools for health facilities and communities.
SSMP championed quality of care as the foundation of accessible services. We worked at community, district and national level to address attitudes and practises that acted as a barrier to women accessing maternal and newborn care. Communications materials such as posters, leaflets, radio and video programmes were developed to help communities learn about safe motherhood and newborn health issues. We worked with communities and service providers to capture and use their "voice" for advocacy and service improvement.
SSMP worked with the National Health Training Centre and other partners to train birth attendants such as doctors, nurses and auxiliary nurse midwives. It also supported the Government to develop basic and emergency obstetric care centres, health posts with birth centres and to strengthen the availability and quality of essential drugs and equipment. SSMP also worked with the government to ensure that the national health information system supported programme needs and key information was analysed and disseminated effectively to enable effective monitoring and evidence-based decision making. These included support to further analysis of the Nepal Demographic Survey, critically reviewing the maternal and perinatal death audit system; integrating mechanisms to routinely collect ethnicity data on service users to help monitor equity and leading on the promotion and facilitation of research in maternal and newborn health.
To learn more about the Support to Safe Motherhood Programme in Nepal, go to the website at www.safemotherhood.org.np
or contact Sarah Hepworth