One Heart World-Wide: 2016 Q3 Report

One Heart World-Wide's mission is to decrease maternal and neonatal mortality and morbidity in remote rural areas. Our partnership with them is helping women in Bhojpur, Nepal receive skilled birth attendant training.

Participants at three-day refresher training.

​SBA Training

​Pregnancy is a natural process for which medical assistance is not considered as a need or requirement in Nepal.  As a result, many Nepalese women, especially those residing in more rural areas of Nepal deliver at home.  In most communities, traditional birth attendants are usually primary service providers who have never received modern training in midwifery. The lack of training poses a risk to the lives of the women and newborn. Currently, there are only a few SBAs that serve about 45,000 women per year in Bhojpur. One Heart World-Wide has identified several eligible nurses that are on their way to becoming certified skilled birth attendants. Post-training, they will be able to provide the maternity care necessary to conduct safe deliveries in this district.

SBA graduation ceremony

BPP/Miso refresher training for health workers and FCHVs at Manebhanjyang.

Local community making an annual work plan in Okhare HP-Bhojpur.

Results from 2016 Quarter 3

• Twenty-one Skilled Birth Attendants (SBA) have received a three-day refresher training in emergency obstetrics (continued medical education)
  
• Five SBAs have received a five-day ultrasound use training at Dhulikhel Hospital. 
  
• 208 health workers and 562 female community health volunteers from 63 different communities received training in birth preparedness and use of misoprostol for newborn care.
  
• A half-day program orientation meeting was organized for 607 local stakeholders from six different village development committees. This is to increase program participation at the community level. 
  
• We started the work with the stakeholders of three health centers to upgrade their birthing centers. 
  
• Our district field team participated in a Reproductive Health Coordination Committee (RHCC) meeting and reviewed existing maternal and neonatal health related challenges in the district, and how best to address them.
  
• Financial and technical support was provided to the district health office to help them improve their data collection system.
  
• Health messages were aired through the local FM stations to improve public awareness in maternal and neonatal health.  
  
• Mr. Yadev Thapa, the previous district coordinator for Bhojpur has been transferred from Bhojpur to Panchtar. We have hired a new district coordinator for Bhojpur, Mr. Rabin Joshi. Mr. Rabin has a background as a District Project Coordinator at Reaching the Unreached (RTU), and also worked at the Human Rights Awareness Centre (HURAC), Rolpa, supported by Save the Children. 

Demonstration on normal delivery during the MNH update training at the DHO, Bhojpur.

Story from the Field: "16 Years of Struggling with the Dark Finally Comes to an End"

Chandra Maya Ingnam, CMA; Ghoretar Birthing Center
Story collected by: Shreya Sharma

​Ghoretar is a remote Village Development Community (VDC) of Bhojpur district consisting of approximately 6,500 in the catchment population. Parts of this region lack the basic necessities of daily living. There is a limited number of healthcare providers, inadequate health services, and also a lack of awareness among the general public in terms of childbirth. 
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During our visit to Ghoretar, we were able to see for ourselves the difficulties faced by the health care center and hear about the challenges faced by its providers. Chandra Maya Ingnam (CMA) is someone who has been working in Ghoretar for the past 16 years.  Chandra Maya, along with her team of providers, has conducted up to 60 deliveries in the past year, the majority of which were in the dark.

Among the women that had to deliver in the dark was 22 year old Sabina, of Ranibas-01. Sabina had labor pains all morning and decided to visit the health center as a result. She was admitted at 2:45 pm and had fully dilated upon Pelvic examination. However, there were complications and Chandra had to recommend that Sabina be referred to the district hospital if she didn’t start showing signs of progress within the next hour.  Sabina was monitored and provided with basic nursing and fortunately, the labor progressed.

However, because she was lacking basic necessities such as a source of heat and proper lighting, Sabina suffered a perineal tear during this process, resulting in profuse bleeding. As Chandra Maya was attempting to repair this tear, the needle broke into two pieces and they had to use torchlights and lights from their cell phones to search for the needle. Despite all of these difficulties, Chandra Maya was able to help Sabina deliver a healthy baby boy and the pair was discharged the next day. 
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Chandra Maya and her team were therefore understandably really excited during the installation of the Solar suitcases and the training session. They expressed genuine enthusiasm and we could sense from their high enrollment rates that the Solar lighting we were installing was important to them. Chandra Maya showed further gratitude for providing hope and facilitating bright lights for the delivery room. “Sixteen years of struggling with the dark has finally come to an end.”

Quotes from the Field

​Mrs. Jamuna Chaulagain, FCHV, Manebhanjyang

Mrs. Jamuna Chaulagain became an FCHV in her village last year. She’s very new to her role and hadn’t received foundation training from the government yet. She didn’t know about maternal and neonatal health until she got a chance to participate in a birth preparedness package training conducted by One Heart World-Wide. She explained to us how important this training was for her work with pregnant women and for identifying complications.

“Birth Preparedness Training is the most important preventive approach to reduce maternal and neonatal mortality and morbidity because it addresses each of the three delays. Through the training, I acquired lifesaving skills like identification of danger signs during pregnancy and prompt care-seeking, education for women and families, and distribution of Misoprostol tablet for prevention of postpartum hemorrhage (PPH).” 

​Anil Phokhrel, HFOMC Chairperson, Okhare Health Post

“I would like to thank OHW for conducting a 3-day health facility operation management committee training on our roles and responsibilities.  We now understand that we are the ones most responsible for improving the service of Health Facility. Going forward, we (Village Development Committee) will also support this collaborative work. We hope we can work together to provide quality services to everyone, focusing on safe motherhood and marginalized communities.”

​Bishnu Gurung, SBA, Annapurna Birthing Center

“I am pleased to say that I had great fortune to participate in a 2-months long Skilled Birth Attendant training from OHW. Before receiving SBA training I had to refer complicated cases to the district hospital, which took more than four hours by vehicle on rough roads or 1 day by foot. This training has improved the way I provide services for newborns and mothers, during pregnancy and delivery. This training improved my knowledge and skills and built my confidence managing the complications related to delivery. I am happy to say that since receiving the training I conducted nearly 25 deliveries in the Birthing Center.”