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Increasing
Access Approaches
The Nepal Safer Motherhood Project (NSMP) takes a multi-faceted
approach to addressing the major barriers to life-saving
emergency obstetric care (EmOC) faced by many Nepali women
in pregnancy and childbirth. These are grouped around four
major input areas:
1. Multi-Sectoral Approaches Involving Partners and District
Safe Motherhood Forums
NSMP believes
that safe motherhood is not just a health issue, but a
major social concern. Therefore, it is vital to involve
a wide range of governmental and civil society organisations
in promoting relevant activities, including awareness raising
among the general public.
NSMP also
uses partnerships with local organisations as a key working
principle. This is in order to:
- Elevate safe motherhood in the
agendas of all major stakeholders.
- Influence policies,
plans and financial allocations.
- Inspire key stakeholders
to come together to exchange ideas and plan safe motherhood
interventions through the creation of safe motherhood networks
at the district level.
- Build a critical mass of advocates willing and able to challenge
harmful social and cultural practices around pregnancy, childbirth
and the status of women at the community level.
- Improve levels
of knowledge on, and attitudes towards, safe motherhood practices
at community and district levels.
- Increase men's appreciation
of women's heath
concerns.
- Advocate for women's increased involvement in family
level decision-making.
- Promote practical solutions to EmOC
(Emergency Obstetric Care) financing and emergency transport
schemes.
2. Behaviour Change Communication (Getting the
Message Across)
At the heart of all of these activities lie specialist
BCC techniques
that use a wide variety of methods and media.
 3. Changing the Social
Context
Through its BCC work,
NSMP seeks to enhance the standing of women within the family and
community and to advocate for their greater involvement in local-level
decision making. To this end, NSMP and
partner staff:
- Lobby local decision-making
bodies to include women's
voices, concerns and needs during planning sessions.
- Bring
together pregnant women and their mothers-in-law to discuss
safe motherhood practices.
- Encourage women to express their health concerns
within the family environment through the use of role-plays,
dramas and puppet shows.
- Include gender awareness sessions as part of
the Foundation
for Change training course run for district-level organisations
such as hospital support committees, Village Development Committees
(VDCs) and Reproductive Health Coordination Committees (RHCCs).
- Celebrate festivals by
widely promoting women's health
issues to the general public.
- Encourage health staff to pay increased
attention to women's
health needs.
- Listen to women, using community based processes such
as the key informant
monitoring tool
to assess women's changing perceptions of their social
status within the family and community.
4. Supporting Practical Needs
- NSMP and its partners also support the establishment
of emergency obstetric funds and transport schemes that enable
practical access to health services. The approach includes:
- Facilitating
meetings of elected bodies, community groups and local leaders
to discuss the financial and transport barriers to access.
- Providing
advice and support for the establishment and management of
emergency obstetric funds and transport schemes.
- Encouraging community members
and local bodies to contribute funds for EmOC financing
and transport.
- Supplying material
support and technical advice to construct patient carriers
such as stretchers and baskets.
- Creating partnerships and links with
other, Nepal-based, organisations that support improvements
to infrastructure.
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