Nepal

White Ribbon Alliance in Nepal, the Safe Motherhood Network Federation of Nepal (SMNF) is working to pass a National Safe Motherhood and Neonatal Health Bill. Members are advocating for increased human resources for health, including family planning provision and increased community awareness of safe motherhood.

3^rd International Safe Motherhood Conference

The Safe Motherhood Network Federation successfully organized the 3^rd annual Safe Motherhood International Conference in Nepal. Nepal was chosen as the site for the conference because of its improvement in safe motherhood practices. The Safe Motherhood Conferencewas designed not only focus onlessons learned, best practices for maternal health and new issues to be addressed for achieving MDGs 4 & 5but also to examine accountability mechanisms to increase access to quality care.

The following were specific objectives of the conference:

• To create a platform sharing the key strategies Nepal used to reduce maternal mortality and new born deaths
• To examine overall improvements in reproductive health of women in Nepal
• To examine progress made in responding to maternal morbidity
• To understand the linkages between safe motherhood and HIV/AIDS
•  To share progress made to improve nutrition of pregnant women and new mothers
• To identify challenges and future directions for Nepal to achieve MDG 4 & MDG 5

During the Inaugural Ceremony plaques of recognition were awarded to senior and distinguished obstetricians and gynaecologists, nurses, mid-wives and FCHVs for their outstanding contribution to pregnant women and mothers in remote communities of Nepal.

SMNF Organizes Advocacy and Awareness Events on the occasion of 2nd World Pneumonia Day, 12 November 2010

The Safe Motherhood Network Federation of Nepal was approached by Save the Children to organize activities to raise awareness and advocate for the prevention and cure of pneumonia for World Pneumonia Day 2010.

Pneumonia causes 1.6 million deaths each year among newborns and deaths in developing nations is 2000 more than in the industrial world. SMNF Nepal and the Nepal Pediatric Society (NEPAS) came together to create public awareness and to urge the government to increase their commitment to prevent pneumonia. In order to maximize media coverage a joint press conference was organized a day before by the partners at the SMNF/Nepal office premises. As it was a new issue, there was extensive coverage.

On November 12th, SMNF organized a rally in Kathmandu, which was attended by more than 1,200 people. Participants carried placards and distributed flyers with difference messages targeted at preventing and curing pneumonia including: treating the disease with antibiotics, increasing access to nutrition, washing hands to prevent infections and reducing indoor pollution. The rally was inaugurated by the State Minister of Ministry of Health and Population (MOHP); the President of SMNF Nepal spoke about the need to prioritize prevention and cure of pneumonia as it had direct bearing on Nepal's progress towards MDG 4. She requested the government to allocate resources for vaccines and awareness about pneumonia. The Secretary of MOHP, Dr. Sudha Sharma stated that the Government of Nepal recognized the importance of addressing pneumonia to reach its commitment to MDG 4. Similarly, Brain J. Hunter, Country Representative of Save the Children, highlighted the importance of increasing vaccine coverage for Nepal to meet MDG 4. The President of NEPAS also lobbied the government for clearer policy and additional resources to address this disease.

Increasing Accountability Amongst Health Service Providers in Nepal

The Maternal and Child Health Project, implemented by SMNF in partnership with the BBC World Service Trust, key regional NGOs and the Ministry of Health and Population is focused on advocacy, raising awareness about safe motherhood and improving accountability of service providers to improve Nepal's
system of health. Out of the 40 planned hearings, SMNF has successfully conducted 15 public hearings from July, 2010 to February, 2011. The public hearings work to identify the gaps in service provision. Problem-solving advocacy groups (PSAG) are set-up in each district with multi-stake-holder participation to resolve issues and improve the health system.

Participants in the public hearings typically include clientele of health institutions, service providers, political leaders, government officers, SMNF members, mothers' groups, media and the public at large. Key findings of the hearings have been lack of timely provision of medical supplies, lack of staff, carelessness and lack of sensitivity of health professionals, ignorance about government schemes, difficulties in accessing health services by marginalized communities and in rural areas, lack of equipment and sufficient beds for deliver, and lack of blood in hospitals. Overall findings point to the need to improve awareness about services and the need to improve health services and coverage.

Photographs: (Top left) Hon. State Health Minister joins the World Pneumonia Day rally (Bottom right) Participant raises question during a public hearing in Morang District of Eastern Nepal.

SMNF Organizes Workshops, Public Hearings and Awareness-Raising Celebrations

Organizing capacity building workshops
The Safe Motherhood Network Federation Nepal organized two capacity building workshops in July and August in Kathmandu, Nepal. The first workshop was organized for 31 non-governmental organization members in the Mid-Western Region of Nepal from 14 to 22 July. This eight-day Master Training of Trainers program focused on various technical aspects related to reproductive health with a special focus on safe motherhood and newborn health, including sexually-transmitted infections, HIV/AIDS, nutrition and gender-based violence. Members also received inputs on leadership skills, facilitation skills, social mobilization, advocacy and behavior change communications. Participants were provided information about the government's health policies and health system, as well as how to do financial management and fundraising. On the last day of the training, participants made district-level action plans.

The SMNF organized a three-day strategic planning workshop for its Board members from 29 to 31 August. The focus of this workshop was on reviewing and sharpening the areas of work identified by members as being the primary focus of SMNF and drawing up action plans to achieve goals.

(Left) A woman speaks up at one of the 40 public hearings that are being held to identify gaps in maternal and child health service provision. (Right) Women participate in a song competition on maternal and newborn health as part of the Teej festival.

Organizing public hearings
The SMNF — in partnership with the BBC World Service Trust, key regional NGOs and the Ministry of Health and Population — is implementing the Maternal and Child Health Project in Nepal. This Project focuses on social mobilization, communication and public hearings and is supported by the European Commission, United Nations Population Fund (UNFPA), United States Agency for International Development (USAID) and United Nations Children's Fund (UNICEF). As part of this Project, the SMNF conducted six public hearings (out of the planned 40) from July to September with the objective of empowering the public with information about safe motherhood entitlements provided by the Government of Nepal and identifying gaps in service provision to improve the health system. Participants in the public hearings included clientele of the health institutions, political leaders, district and village-level health workers, Chief District Officers, SMNF members, mothers' groups, members of the media and the public at large. Problem Solving Advocacy Groups (PSAG) have been formed in all six districts to resolve issues identified during the public hearings. Some of the issues identified pertained to lack of timely provision of medical supplies, lack of staff, carelessness and lack of sensitivity of health professionals.

Celebrating National Women's Festival
Teej is a festival dedicated to women and the celebration of womanhood. Thousands of women gather dressed in red all over Nepal to bond together and express themselves through song and dance. This year SMNF again organized Teej festival celebrations on 2 September in 14 districts of Nepal to create awareness amongst women about safe motherhood and other reproductive health issues. In each district, more than 500 people participated in song competitions that focused on the theme of safe motherhood and newborn health. During the celebration, SMNF volunteers also distributed leaflets and other relevant information, education and communication (IEC) materials to raise awareness about safe motherhood, newborn health and safe abortion care.