Nepal Safer Motherhood Project - Working to improve the Utilisation of Quality Midwifery and Essential Obstetric Care Services in Nepal


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	Project Goals

	Policy Development
	Using project learning to influence HMGN's Policy and Planning

	Service Provision
	Improving the quality of Essential Obstetric Care available in certain districts within Nepal

	Increasing Access
	Stimulating demand for Essential Obstetric Care services and overcoming the barriers that restrict Nepali women's access to them.

Policy Development

The Nepal Safer Motherhood Project (NSMP) supports the development of His Majesty's Government of Nepal's (HMGN's) National Safer Motherhood Plan and policy in two main ways:

By using the experience of implementing its district-level programmes to influence the government's thinking, planning and policy development. This approach is called 'rooted advocacy'.
By supporting initiatives of emerging importance that, though sometimes unrelated to current district-level experiences, are critical for the long-term development of the sector. An example is promoting the safe abortion agenda.

NSMP is able to achieve these strategies due to its high levels of internal technical expertise, combined with an excellent working relationship with HMGN's Health Divisions.

The strategies have led to some significant changes. For example, the role of nurses and paramedics has been expanded to providing emergency obstetric care (EmOC) by:

Developing National Reproductive Health Protocols for all key types of staff.
Piloting and accrediting Post-Basic Midwifery Training Course for nurses.
Piloting and receiving approval by HMGN of a Post-Abortion Care Training Course for nurses.
Piloting and accrediting a Refresher Midwifery and Obstetric Care Training Course for nurses and Assistant Nurse Midwives (ANMs).
Piloting an Anaesthetic Assistant Training Course for health assistants and nurses.
Developing and piloting a Midwifery and Obstetric First-aid Training Course for maternal and child health workers (MCHWs).

a group of women sat down watching a performance. NSMP has also had significant influence on health sector planning. This includes making a major contribution to HMGN's 15-year Strategic Plan for Safe Motherhood and supporting the establishment of a national Essential Obstetric Care (EOC) monitoring system that includes a national maternal death audit compiled from district level data.

In addition, the project helped to develop a national Safe Motherhood Information, Education and Communication (IEC) strategy, piloted a BEOC course for medical officers and developed National Infection Control Guidelines.

In December 2003, abortion became legal in Nepal, with NSMP a leading advocate, researcher and contributor to the discussions. The project A collection of NSMP reading material also currently supports the Technical Committee for the Implementation of Comprehensive Abortion Services (TCIC).

In addition to its work in Nepal, NSMP has been an active player at an international level. Project staff have presented papers at several major international conferences, hosted technical meetings and established important links with many other sectors and networks.

2004 will see the Department for International Development (DfID) continuing to support safe motherhood in Nepal with a 5-year programme of support for the implementation of the Nepal National Safer Motherhood Plan. This will also be managed by Options.