By Amrendra Ray in Sarlahi, Nepal | OHW Nepal Staff
One Heart Worldwide’s work in the hill and mountain districts of Nepal is well known across the country for its impact on improved maternity care. We are hoping we can continue to build OHW’s legacy in Madhesh Province (formerly known as Province No. 2), where OHW introduced its MNH program in 2022 for the first time. Madhesh Province, bordering the Northeastern part of India, is much different from the other areas we have worked in. Instead of vast mountain ranges, we are working in the southernmost region of Nepal where the terrain is mostly plains. Local government officials and rural health service providers are looking forward to learning how OHW can use its proven experiences to impact the health and well-being of people who give birth in Madhesh Province.
Sarlahi has Nepal’s second-lowest literacy rate. During our baseline survey, we found that the level of knowledge and awareness around pregnancy is so poor, that a large number of recently delivered mothers and their families are not even aware of the existing government incentives (ex: cash incentives for institutional birthing). Most birthing centers are in poor condition and lack proper equipment and tools.
Many nurses are not trained as Skilled Birth Attendants (SBAs) and therefore their skill acquisition is lower than other parts of Nepal.
There is low investment in maternal and neonatal healthcare and its infrastructure.
A lot of government guidelines for quality birthing centers are not actively put into practice.
We also found that cultural and social norms affect women’s decision-making.
Women constantly need permission from male household members to even go to health facilities to obtain services.
All of these and many other factors are putting the lives of many pregnant women, mothers and infants at high risk.
OHW aims to address these issues and work in close partnership with local governments by providing technical support and contributing financial resources. The idea of partnerships with non-government organizations (NGOs or non-profits) in the health sector is quite new for our local government and there is already a lot of enthusiasm to learn and collaborate. We have been consistently coordinating with local government, health units and officials to work as partners and make MNH a priority in their development, planning, and budgeting.
While there are several organizations working in the health sector in Madhesh Province, they are not fully invested in MNH and only work in a few municipalities. OHW is fully invested to make a difference and has been working in all 20 municipalities/local levels within Sarlahi district.
Building new birthing centers and providing medical equipment is not enough - and we know that thanks to our conversations with people who live in the communities we work in. There is a need to allocate financial resources, involve government leadership and train service providers - all of which are key to making our MNH program a big success.
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By Ashmita Hamal and Naresh Newar | OHW Nepal Staff
By Naresh Newar | Communications Consultant
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