The maternal mortality rate of Nepal is one of the highest in the world. Nearly 93 per cent births take place without medical aid and under unhygienic conditions. A small survey conducted by RUWDUC in 1995 revealed extremely poor conditions of women, especially pregnant women, in the far western region of Dadeldhura district. Living under difficult conditions, they are married off at a young age and become pregnant at an early age also. Low maternal care during anti-, pre- and post-natal stages, closely spaced pregnancies, and social and cultural preferences for a male child are major factors responsible for maternal and child deaths.

This programme was conceptualized bearing in mind the poor conditions of young girls and women and the lack of attention given to their health. The health and sanitary conditions of the majority populace of the district remains extremely poor due to a lack of health awareness and inaccessibility of the larger population to existing health facilities. Thus, with financial support from the Britain Nepal Partnership Fund, RUWDUC established a Low Risk Birthing Center (LRBC) situated in Jogbuda VDC, in the terai belt of Dadeldhura District. A local SLC pass girl, was identified and provided scholarship to become an ANM, by RUWDUC and upon completion of her studies was operating the Birthing Center.

 Objective

• Provide pre natal, ante natal, post natal and normal delivery services.
• Awareness Raising on Reproductive Health/Safe-motherhood issues through collection and distribution of IEC Materials (posters, pamphlets) and orientations.
• Orientation/trainings to existing Women’s Group, Female Community Health Volunteers (FCHV) and adolescent youth on the importance of safe-motherhood/ reproductive health issues and relevant contextual social norms and values.
• Promotion of the Low Risk Birthing Center and its services.
• Provide referral services.

Target Areas

The programme was conducted in the three most populous VDCs of Jogbuda, Alital and Sirsha situated in the southern part of Dadeldhura District.

 Major components/Activities

 Providing general health check-ups to adolescent girls, pregnant women, lactating mothers and young mothers were the major function of the LRBC. Its principal function was to provide ante-natal, pre-natal and post-natal check-up and provide assistance during normal deliveries. Medicines such as vitamins, iron tablets, frolic acid tablets and etc. were also distributed. Complicated cases were referred to the Team Hospital in Dadeldhura Municipality or the Government Hospital in Dhangadi District. The LRBC also aimed to strengthen and assist existing government health infrastructure such as Health Posts and Sub-Health Posts in the surrounding area. The interest of the community in utilizing the birthing center had been very keen and the overall impact of the project proved to be very beneficial to the target group, which includes women and children of the area. The LRBC provided its services to a total of 12,463 women and children of Jogbuda, Alital and Sirsha VDCs since its establishment. Following are some data:

Complicated deliveries such as vacuums delivery, retained placenta, cord round, delivery of twins, etc. were also conducted in the center.

Mobilization and creation of awareness especially, amongst young women, on the importance of reproductive health and provision of primary level gynecological services was a prime activity of this programme. Women’s Groups were used as a medium to encourage pregnant women and young mothers to access the services of the Low Birthing Center. The awareness program enabled the people to become more aware of maternity issues as a result of which there was a substantial increase in the visits being made to the LRBC.

Orientations on safe motherhood were provided to 409 individuals including mothers and fathers of local community groups, multi sectoral groups, community leaders, health providers and TBAs. Orientations were also provided on contextual social norms and values and the importance of Reproductive Health and Safe Motherhood issues were also provided to 81 representatives of existing women’s groups of the VDCs of Jogbuda, Alital and Sirsha.

Refresher orientations A refresher course was provided to 114 Female Community Health Volunteers (FCHV) on critical issues such as Reproductive Health, Safe Motherhood, Nutrition Education, Violence Against Women and Family Planning. The overall goal of this programme was to re-activate the FCHVs and encourage them to motivate pregnant women and mothers to seek necessary services at the RUWDUC Birthing Center as well as other government facilities.

Upon completion of the programme in 2005 the Birthing Center (both building and equipments) were handed over to the newly established District Hospital in Jogbuda VDC of Dadeldhura District.

Time Frame : November 1996 – June 2005