Summary

Key program components

With the help of the Village Health Workers (VHW) all pregnant women will be visited in their homes monthly to receive information about nutrition, the development of their fetus, hygiene, and warning signs to look out for during pregnancy. These monthly services will also provide proper screening and care for the mother.

In their 8th month each mother will receive a home birth kit. This is to ensure that the mother will at least have the needed materials for a hygienic birth if she chooses to stay at home for her delivery, does not have time to reach a healthcare facility, or is not able/does not wish to call the VHW. Each birth kit will include clothes for the baby at the time of birth, receiving blanket, sterile cord clamps, a sterile razor for cutting the cord, soap to wash hands, medication to stop hemorrhages, and an instruction sheet to guide the woman through the birth. Instructions are written in Nepali with illustrations for the illiterate woman. The VHW sells the kits for the cost of the materials enclosed plus a moderate mark up to provide income for the VHW. The receiving blanket and clothes for the newborn will be subsidized by ECTA.

VHWs are trained by ECTA to oversee births in a hygienic and compassionate manner, to identify signs and symptoms which warn of potentially life threatening conditions, and give the VHWs confidence to transport these women in their time of need. They are equipped with proper instruments and training necessary to prevent a maximum number of mother-child mortalities. Mothers will also receive post-partum visits so that potential complications, such as infections, can be identified before they become serious.

There will be four levels of potential care made available to every mother:

Level 1: Basic birth kit for an unattended home delivery

Level 2: An assisted home birth attended by a trained and equipped VHW.

Level 3: Treatment given by a healthcare professional inside the ambulance or at the Kaffer clinic.

Level 4: Emergency transport in the Naya Jeevan Ambulance to a hospital with surgical facilities.

This initiative will give women who decide to deliver at home a healthier birth and provide access to specialized care for those who desire help at the time of delivery. Another important aspect of the initiative is the development of community based health care. The Dayako Sagar Maternal Health Program was created cooperatively with members of the village community in order to create local ownership and sustainability.