Improving maternal and newborn health in Nepal in partnership with Ministry of Health: Voices from the field

Post authored by Dushala Adhikari, one of Medic’s Project Managers based in our Kathmandu office. 

Every day in Nepal, six women die from preventable pregnancy-related health conditions due to inaccessibility of timely care before, during, or after delivery. Many of these deaths are caused by three infamous delays – delays in identifying danger signs and deciding to seek care, in locating and reaching a healthcare center, and in accessing appropriate medical care that would prevent such deaths. Underlying this are a host of medical, social and structural constraints. One of the most important factors however, is the sluggish process of identifying and communicating about maternal health care needs.

In this context, Medic supports the national health care delivery system in its efforts to reduce the risk of a mother dying from pregnancy and childbirth-related health issues. Medic’s SMS tools to support maternal and child health care help female community health volunteers, health care providers and program managers to actively reach out to pregnant women, identify high-risk pregnancies, and ensure that the they receive technically sound and culturally appropriate health care. Since 2012, these health workers have registered 46,301 pregnancies across several districts using the Medic platform.

Research conducted by our team and by independent investigators has found that this kind of interactive texting is highly affordable and can expand the reach of services by making community health tasks far more efficient. In the context of an antenatal care programs, these tools make it easier for health workers to prevent maternal deaths by immediately reporting the mother’s’ health care needs and quickly responding with appropriate care. The program also helps identify maternal deaths, facilitating the rapid exploration of the circumstances of such events, enabling health system-wide responses.

 Sabitri, Female Community Health volunteer in Matehiya village of Banke on her way to visit a pregnant woman.

In partnership with Ministry of Health, municipalities and few non governmental organizations, we are rapidly scaling up the implementation of this mHealth program across the country, with a focus on long-term sustainability and interoperability with national health information systems.

At the same time, we continue to pay close attention to our users in the field as they share their experiences, feedback for improvements, and hopes for the future of this program. Here are a few voices from the field gathered from recent visits to several districts:

“Earlier, we used to refer pregnant women to the health facility only if we met them by chance. But now, we get regular reminders and convey it to them. None of the pregnant women are missing now. ” – Anjana Majhi a female community health volunteer working in Sindhuli of State #3.  

FCHV Anjana Majhi showing reminders she received for ANC visits of one of the pregnant women in her catchment during supervisory visit to her home

“Many pregnant woman do not come for antenatal check-ups in time. Before, we would call each of them from our personal mobiles. Now, we are happy that this mHealth tool is going to help us by sending the automatic reminders. This will save our time and cost of calling them frequently,”  says Dibya Neupane, Incharge of Puja Health Post, Gaumukhi Municipality, Pyuthan.

“We are thankful to Medic for providing us with this helpful tool. Now we will work together to ensure that all pregnant women will come to the health facility and will receive all antenatal services. None will be delivering babies at home in unsafe conditions, every child will receive all the vaccines and most importantly, no mothers will die because of not getting the health service in time.” – Bishal Subedi, District Public Health Officer, Pyuthan district.

Bishal Subedi, Chief of District Public Health Office Pyuthan starting mHealth training of trainers for health facility managers in his district.

“We have committed to provide service to the people living in remote areas. It is time to deliver results in terms of net gains in health outcomes. Medic’s technology is indispensable in this regard” – Netra Bahadur Bohora, Mayor of Sorgadwari Municipality, Pyuthan

Netra Bahadur Bohora, Mayor of Sorgadwari Municipality giving his remarks about mHealth to a group of health workers.

“After using Medic’s tool in several districts, we realised the need to scale-up. This tool will help us build a health system that is accountable to the people. We from the Ministry facilitate an enabling ecosystem for mHealth, the local government allocates financial resources for implementation, and Medic provides the technology. These elements together form a successful partnership model with potential to overcome the challenges of mHealth implementation.”  – Shival Lal Sharma, Statistical Officer at Public Health Administration Monitoring and Evaluation Division, Ministry of Health and Population informing elected members and health workers about mHealth and the Medic platform.

We are proud and honored to support FCHVs, health workers, supervisors, officials and policy-makers as we work together to strengthen Nepal’s health system and ensure that every pregnant woman receives the care she deserves.

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