Maternal, newborn and Adoloscent Health Promotion Project, 2024- 2025, EDM


Contribute to improve maternal, newborn and adolescent health (MNAH)


In Nepal, despite a lot of progress has been made during the last decade in terms of decrease of mortality rates for women and new-borns and coverage of maternal and newborn healthcare services, the public health system is characterized by important shortcomings: notably, lack of human resources, medical material and equipment, and supervision are leading causes for the poor care offered in the health facilities to pregnant women and new-borns. In addition, according to an analysis done by our partner NGO, health facility staff shows poor interpersonal communication skills with pregnant women and their families, often mistreats women during care, regularly does not respect privacy and confidentiality of women, and frequently practices medical procedures that are not necessary for the health of the women, or without the patients’ consent. The 2021 Nepal Health Facility Survey confirmed that counselling to women and families during pregnancy is insufficient: only 38% of mothers are counselled on birth preparedness and complication readiness, 23% on at least three danger signs in pregnancy, 16% on new-borns care, only 2% receive an early initiation of breastfeeding, and 2% are informed on vaccination to the child. 28% of the health care providers maintain privacy with divider between beds; and 18% of the staff scolds or treated the clients disrespectfully. Only 54% of the staff explained the procedures in a language the client can understand and encourage the client to ask questions. 23% of postpartum women interviewed after their delivery reported that the staff had scolded them or treated them disrespectfully.

Adolescent sexual and reproductive health (ASRH) is problematic in Nepal. According to information collected by our partner organisation, ASRH related issues are not discussed in communities/families, and adolescents continue to be exposed to many myths and misconceptions due to low awareness among the population. Sexual relations before marriage are socially unaccepted in Nepal. Adolescents' and young people's concerns about sexuality and the physical and mental changes associated with it are not openly discussed within the families. Communities try to hide cases of sexual violence. For many school-age girls, the main reasons for dropping out of school, besides economic hardship, are early marriages and unwanted pregnancies. Nearly 50% of the adolescent pregnancies in Nepal are unwanted. Only about 23% of the adolescents use family planning in Nepal. This situation is the result of the poor quality of education and health services.


A first component aims at contributing to improve the health of disadvantaged pregnant women/mothers and new-borns mostly living in disadvantaged suburbs of industrial areas in three districts of Lumbini province. This axe builds on the positive experiences of the first phase 2022-2023. During this period, the programme has trained 220 health facility staff (nurses, paramedics and administrative staff) in 20 health centers located in the districts of Nawalparasi, Rupandehi and Kapilvastu, as well as stakeholders at municipality, district and provincial level in maternal and new-born respectful care (RMNC) to improve how women and newborns are treated during care. This has been done in close cooperation with the National Health Training Centre (NHTC) which was involved in the elaboration of training material. Representatives of NHTC have been part of the master trainers’ group that elaborated a trainers’ handbook and guidelines for trainers and trainers’ reference materials and also trained the group of trainers on this basis.

A second component of the programme aims at contributing to improve the sexual and reproductive health of adolescents (ASHR) living in disadvantaged suburbs of industrial areas in the same three districts than the RMNC component. This component has been newly developed based on the context analysis and the needs identified in this field (see point 1). The programme will intervene in both public schools at secondary level and health centres. A trainers’ team will be formed and trained in the fields of CSE (comprehensive sexuality education) and ASHR, based on training material developed by the Ministry of Education, and Ministry of Health and Population.


  • The present fund request covers the years 2024-2025, the two first years of the overall programme duration from 2024 to 2028.
  • The impact of the programme is to contribute to improve the maternal, new-born and adolescent health in the districts of Nawalparasi, Rupandehi and Kapilvastu in Lumbini Province.
  • Indicators: Increase of % of pregnant women giving birth at health facilities (baseline: 88%, target 2024: 90%, target 2025: 94%).
  • Increase of % of adolescents who know about safe sexual practices (baseline: 37.1%, target 2023: 70%, target 2025: 80%).

Expected outcomes Planned outputs and main activities

1. Health care providers deliver respectful care to women and new-borns Output 1.1. The online training module is endorsed and included in the SHP package by the National Health Training Centre (NHTC)
Main indicator: % of women satisfied by the care received at the health facility
Baseline: 70% Target 2024: 80% Target 2025:85% Main activities:
·        Revision of online training on RMNC based on the feed-back received from participants of the pilot training conducted in 2023
·        Workshop with NHTC for endorsement of the revised version of the online training
Output 1.2. Trainers from NHTC training sites are trained in RMNC
Main activity:
·        Training of 50 trainers in RMNC (25 in 2024 and 25 in 2025)
Output 1.3. Health workers in public health facilities are trained in RMNC
Main activities:
·        Printing of training materials for trainers already developed in 2022- 2023  
·        Review meeting with health workers trained in 2022 / 2023
·        Initial training of 155 nurses and paramedics in RMNC (55 in 2024 and 100 in 2025)
·        Continuous training of 155 nurses and paramedics in RMNC (55 in 2024 and 100 in 2025)
·        Distribution of mothers’ handbooks in the health facilities
2. Women and adolescents participate in assessing care at health centres Output 2.1. Women’s groups meetings with FCHVs and meetings among peer leaders are held
Main indicator: Main activities:
% of women and adolescents satisfied by their participation in the meetings ·        Conduction of orientation sessions on social accountability for 310 FCHVs (110 in 2024 and 200 in 2025)
Baseline 54% women, 75% - Targets 75% women 2024, 85% women 2025 ·        Implementation of refresher sessions on social accountability for the 110 FCHVs oriented in 2024 in 2025
Targets 80% adolescents 2024, 85% adolescents 2025 ·        Conduction of orientation sessions on social accountability for 10 municipality officers (5 in 2024, 5 in 2025)
·        Organization of 325 meetings (250 in 2024 and 75 in 2025) between 8’400 pregnant women / post-partum women and FCHVs (6,750 women in 2024 and 1,650 in 2025)
·        Organization of meetings among adolescent peer leaders on social accountability
Output 2.2. Joint meetings of women/FCHVs and adolescent peer leaders with health facilities and municipalities are held
Main activities:
·        Organization of 10 meetings between women/FCHVs and health facilities / municipalities
·        Conduction of satisfaction survey with 150 women per year
·        Formation and mobilization of municipality project advisory committees (2 in 2024 and 2 in 2025)
·        Organization of 3 meetings between adolescents and health facilities/ municipalities (1 in 2024, 2 in 2025)
Output 2.3. Action plans to improve the quality of the health services for women and adolescents in the health facilities are developed
Main activities:
·        Elaboration of 1 action plan per year and health facility to improve quality of MNH services (11 in 2024, 20 in 2025)
·        Elaboration of 1 action plan per year and health facility to improve quality of adolescent-friendly health services (10 in 2024, 15 in 2025)
3. Health care providers deliver adolescent-friendly health care Output 3.1. Health facility staff in 35 health centres is trained on adolescent-friendly care
Main indicator: % of adolescents satisfied with information received at health facility Main activities:
Baseline: 56%8 Target 2024: 65% Target 2025: 75% ·        Conduction of preparation workshop for 8 trainers (for ASRH in health centres and CSE in schools)
·        Printing of pedagogical material for trainers on ASRH and CSE
·        Conductionofinitialtrainingof60healthcareprovidersinadolescent-friendly health care (20 in 2024, 40 in 2025)
·        Implementation of continuous training in 2025 of the health care providers trained in 2024
·        Orientation of the members of the Health Facility Operation and Management Committees (HFOMC) in adolescent-friendly health services
Output 3.2. Adolescent sexual and reproductive material is provided in the health centres
Main activities:
·        Development, printing and distribution of ASRH booklets in 35 health centres
·        Output 3.3. Minor structural adjustments/renovation of health facilities are provided
Main activity:
- Provision of needs-based support to 35 healthcentres (10 in 2024,25 in 2025)
Outcome 4: Comprehensive sexual education (CSE) is delivered in school and out-of- school ·        Output 4.1. Teachers are trained in Comprehensive sexual education (CSE)
Main indicator: % of adolescents satisfied with CSE received Main activities:
Baseline: 8.6% Target 2024: 50% Target 2025: 70% - Conductionofinitialtrainingof83teachersinCSE(34in2024and49in 2025)
·        - Conduction of continuous training for 34 teachers in CSE in 2025
Output 4.2. Minor adjustments of schools are made to promote an adolescent-friendly environment
Main activities:
·        - Provision of needs-based support to 35 schools (10 in 2024, 25 in 2025)
Output 4.3. Adolescent peer group leaders are trained in CSE
Main activities:
·        Formation and mobilization of peer groups
·        Conduction of initial training of 40 peer group leaders in 2024 and 60 peer group leaders in 2025 in CSE
·        Conduction of continuous training of 40 peer group leaders in 2025
·        Organization of meetings of adolescent peer group leaders
Output 4.4. Sensitization events for adolescents on CSE are conducted in-school and out-of-school
Main activities:
·        Organisation of sensitization sessions on CSE for 525 members of the School Management Committees (150 in 2024 and 375 in 2025)
·        Organisation of sensitization sessions on CSE for 22’032 in-school adolescents (6,516 in 2024 and 15,516 in 2025)
·        Organisation of sensitization events on CSE for 3,811 out-of-school adolescents (1,303 in 2024 and 2,508 in 2025)
·        Conduction of sensitization campaigns on CSE for 3,000 adolescents on social media
Output 4.5. Coordination between education and health authorities takes place
Main activity:
·        Organisation of joint meetings between health and education authorities and political leaders (105 persons, 30 in 2024 and 75 in 2025)

Contact address

Name:  Constanze Bunzemeier Ram Chandra Silwal
Organisation Enfants du Monde (EdM) Green Tara Nepal
Route de Ferney 150, 1211 Genf  2    GPO 8974, CPC 158, Kathmandu, Nepal
Tel: 022 798 88 81 Tel: 977-1-4432698, 98510-22220
e-mail: e-mail: Ramsilwal99@Gmail.Com,