Respectful Maternity and Neonatal Health Promotion Project

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Respectful Maternity and Neonatal Health Promotion Project


Improving the health of urban mothers and their newborns during COVID-19 crisis in Nepal


Description of the Project

The people, who settled in the industrial areas, have been heavily affected by COVID, directly due to contracting the infection because of lack of information and protection means, and indirectly by the economic crisis. Moreover, during the COVID crisis, the fragile primary and secondary health system in slums have not been able to respond to the needs: Health facility staffs including nurses, paramedical and administrative staffs were working with limited resources.


Pregnancy and childbirth are still a leading cause of death, disease and disability among women of reproductive age in Nepal: The National Demographic Health Survey (NDHS) 2016 showed that maternal mortality ratio in Nepal was 239 per 100,000 live birth. Only about 59% of the women complete the 4 recommended ANCs during pregnancy. According to country data, only 56.2 % of women complete the 4 recommended ANCs and 16.4% complete the PNC check-ups in the district of Lumbini. 


Objectives

The project aims at contributing to improve the health of women and newborns living in the slums of industrial areas of the Kapilbastu, Rupandehi and Nawalparasi West districts targeting improvements in two components of care. The first component, at community level, targets urban pregnant women and new mothers, improving their knowledge to seek skilled MNH care and protect themselves, their babies and their families. The second component, at health facility level, strengthens the capacities of health facility staffs to protect themselves from COVID infection, to protect pregnant women, new mothers, and their babies and to provide respectful MNH care. This project also strengthens the health staff’s skills to respect women and newborns during MNH care, effectively counsel and communicate with women, their partners and families during routine and emergency care in pregnancy, childbirth and postnatal periods. Health facility teams will develop knowledge on the rights of women and newborns to health and to high quality care before, during and after childbirth, including for women. 


Implementation Strategies

The project will be implemented in collaboration with municipalities and Health Facility Operation and Management Committees (HFOMCs). Depending on the success of the implementation phase, based on the monitoring data an analysis will be conducted at the end of 2023 in view of scaling up the project component on respectful care and replicating the activities in other health facilities with the support of the local governments.


Key Focus of the Project

Abuse-free care

  • Never physically or verbally abused

  • Never restrained physically

  • Touched in a culturally appropriate way

  • Never separated the baby from mother

  • Never denied food and fluids

  • Provided comfort/relief

Right to information, informed consent, and choice

  • Introduced self to women and her companion

  • Encouraged companion to stay with women

  • Encouraged to ask questions

  • Responded questions promptly and politely

  • Explained the procedure

  • Provided periodic update

  • Allowed to move during labor

  • Allowed to assume the birth position of choice

  • Obtained consent before the procedure

Confidential care

  • Stored file in locked cabinets

  • Used curtain or visual barrier

  • Used drapes and covering

Dignified care

  • Spoke politely to women

  • Allowed non-harmful cultural practice

  • Never insulted and intimidated

Equitable care

  • Spoke in an understandable language

  • Never disrespected & discriminated the women

Non-abandon care

  • Encouraged to call if required

  • Came quickly when called

  • Never left women alone


Outcomes, indicators and activities

Intermediate Outcome 1: Women and communities take decisions of seeking MNH care and protect themselves and their family from COVID

Immediate Outcomes

1.1 CMs and FCHVs know the importance MNH care and know how to protect themselves, women, their babies and their families during COVID

Output

Indicators

Activities

1.1.1 Training material for CMs and FHCVs is available

  • 500 of training guide available on COVID/MNH developed and distributed  (1 is developed, 500 are printed and distributed)


Developing and printing training material for CMs and FHCVs 

1.1.2. A team of trainers is trained


  • 18 of trainers trained 


Training of trainers 


1.1.3. CMs and FCHVs are trained on the importance for women to seek MNH care, COVID and the effects of COVID on MNH

  • 3 of CMs and 180 FHCVs trained 


Training of CMs and FHCVs

1.2 Urban pregnant women and new mothers know the importance of seeking skilled MNH care and know how to protect themselves, their babies and their families during COVID 

Output

Indicators

Activities

1.2.1. Pregnant women, new mothers and their family have received information on the importance of seeking MNH care, COVID and COVID/MNH 


  • 10000 of women receiving information on the importance of seeking MNH care among them participate in home visits or participating to Health Education Session)

  • 7000 husbands participating to Health Education Session

  • 30000 of other family members participating to Health Education Session


  • Home visit/Education sessions by CMs and FCHVs (including meetings with women and adolescents)

  • Developing and printing of leaflet and flipchart 

  • Coordination meetings 

  • Coordinator monitoring visits 

1.2.2. Pregnant women, new mothers and their family have received COVID protection Kit


  • Nb of urban pregnant women and new mothers receiving COVID protection kit

  • Nb of husband and other family members receiving COVID protection kit


Procurement, supply and distribution of COVID protection kits

Immediate outcome 2. Health facility staffs provide quality MNH care for pregnant women, new mothers and their newborns

Output

Indicators

Activities

2.1. Health facility staffs know how to provide respectful MNH care to women 

  • - Above 90 % of Health staffs who are able to give 3 examples of respectful care in MNH 

  • - above 80% of the clients visiting to HFs for MNH care are satisfied the servies 


2.1.1. Training material for Health facility staffs is available 


  • 200 of training guide developed and distributed (1 is developed, 200 are printed and distributed)


Developing and printing training material on respectful care for Health facility staffs

2.1.2. A team of trainers is trained 

  • 171 of trainers trained


Training of trainers 


2.1.3. Health facility staffs are trained to provide respectful MNH care to women and newborns

  • 171 of Health facility staffs trained 

  • In 20 Health facilities of Medical equipment provided

  • 20 health facilities of Maintenance and repair services provided


Printing and distribution of guidelines on respectful care

Training of Health Facility staffs


2.1.4. Health facilities are equipped with material for quality MNH health care


20 of Health facilities equipped with medical equipment / kit for MNH care

Procurement, supply and distribution of medical equipment for MNH

Training of Health facility staffs on MNH equipment

2.2. Health facility staffs know how to protect themselves from COVID infection and how to protect pregnant women, new mothers, and their babies 

- 171 of Health Facility staffs who protect themselves from COVID

2.2.1. Health facility staffs are trained to protect themselves from COVID and effects of COVID on MNH 


  • 171 of Health facility staffs trained on  COVID, use of PPE, effects of COVID on MNH 

  • COVID-19 management guidelines available in the 20 health facilities (200 copies of guidelines distributed) 


  • Impression and distribution of COVID management guidelines

  • Developing training material for Health facility staffs

  • Training of 15 trainers

  • Training of Health facility staffs

  • Orientation of the HFOMC


  • Coordination meetings with the Social Welfare Council, DHOs and Municipalities


  • GTN Manager monitoring visit with DHO and Municipality Officers


  • Social audit with health staff stakeholders

2.2.2. Health facilities are better equipped with PPE 

  • 10000 of PPE equipment distributed 


  • Procurement, supply and distribution of equipment

  • Training of Health Facility staffs on PEE equipment


Contact address

Name:  Constanze Bunzemeier

Organisation Enfants du Monde (EdM)

Adresse: Route de Ferney 150, 1211 Genf  2   

Telefon: 022 798 88 81

Mail: constanze.bunzemeier@edm.ch

Website: www.edm.ch 


Ram Chandra Silwal

Green Tara Nepal

GPO 8974, CPC 158, Kathmandu, Nepal

Tel: 977-1-4432698, 98510-22220, 9841-415889

e-mail: ramsilwal99@gmail.com

rsilwal@greentara.org.np

website:www.greentara.org.np