Supporting implementation of Nepal's National Safe Motherhood Programme and its integration into wider health sector reform processes
The Support to the Safe Motherhood Programme (SSMP) 2005–2009, provided embedded technical support to the government of Nepal to improve maternal and newborn survival. SSMP worked in collaboration with government and non-government stakeholders to support evidence-based planning, and strategy and policy development at state and district levels leading to support implementation. Options provided technical assistance to support the development of key policies, strategies and protocols including: skilled birth attendant policy; blood products protocol; procurement in maternal and newborn health policy; the remote area strategy; the maternity incentive scheme and free delivery policy.
The programme raised the profile of maternal health by increasing the numbers and utilisation of skilled attendants and emergency obstetric care services. We implemented UK Aid’s largest demand side programme (equity and access) which contributed to increased and more equitable utilisation of maternal newborn and child health services. The SSMP programme has provided technical support to strengthen the health management information system, including the establishment of emergency obstetric care monitoring across 19 districts and has supported the government of Nepal in the development and implementation of a monitoring and evaluation programme for the new free delivery care policy.
Many studies have documented SSMP and its predecessor NSMP’s success in reducing maternal mortality. During the 14 years that Options provided technical support in maternal health in Nepal, maternal mortality halved from 539 to 281 deaths per 100,000 live births (Nepal Demographic and Health Survey, 2006).
Prior to SSMP, Options managed the Nepal Safer Motherhood Project (1997 to 2004) with the Family Health Division in ten districts to reduce maternal deaths by improving the quality of public maternity services and enabling more women to use such services, by working with local groups. The Nepal Safer Motherhood Project also supported the development of national safe motherhood policies and plans by drawing on district experience to inform national policy and by supporting national initiatives, such as legalisation of safe abortion.