"We hope to offer to all women in need a decent, friendly and safe place for giving birth."
The number of girls and women who had their first antenatal visits between July 1, 2013 and June 30, 2014.
Estimated girls & women affected
The number of women who attended microfinance and health groups between July, 1 2013 and June, 30 2014.
Estimated community members affected
One year ago you chose to support us in reducing maternal and newborn mortality through the empowerment of women, access to qualitative reproductive health services, health education, awareness, and referral. The planned infrastructure has been implemented in each location. Private and hygienic spaces for reproductive health are now available and include an environmentally friendly medical waste management. All equipment has been distributed to the health centers including: delivery beds, safe delivery kits, kits for the newborn resuscitation, and hygiene and sterilization kits. Each of these donations have been accompanied with specific training, protocol, and guidelines to ensure their proper use.
Ten staff members have been trained as skilled birth attendants. More than 200 men and grandmothers participated in our health education sessions. As they are often seen as the decision makers in the family, it is critical that they understand the importance of ante-natal care and how deliveries by Skilled Birth Attendance make a huge difference. Finally, all members of the cooperative received microfinance training to encourage sustainable access to reproductive care. Our objective now is to replicate our program in other areas, since research has indicated the necessity for our program to be implemented at a larger scale.
"We hope to offer to all women in need a decent, friendly and safe place…for giving birth." - Doctors of the World staff member
Risks and challenges
In many rural Nepalese communities, women and girls have to sleep in the cowshed when they are menstruating. During that time a woman is considered impure, cannot come near the family house and must be isolated for 12 days. Delivering is also considered impure. The blood and bodily secretions associated with childbirth are widely viewed as unclean and polluting. As a result, most people are reluctant to help women who require obstetric assistance. In this context, training and maintaining skilled birth attendants capable of providing pre and post natal care in remote areas are challenging. Educating communities, empowering women, and ensuring more continuity of the health services are our priorities.
What we’ve learned
The originality and sustainability of the project depend on the involvement of women in microfinance activities and their participation in education sessions on prevention, pregnancy managment, childbirth, and post-natal care. Through these sessions, women realize the importance of having access to health services. They can also improve their financial independence through better management of the family budget.
Women’s empowerment remains key to mothers’ health and newborn mortality reduction. An important assessment was conducted by five teams during a seven week period. They visited the most remote and difficult to access areas, in order to identify the needs and feasibility to further the project. The hope is to create a pilot program not only for regional development, but also to allow others to use the sustainable model in different contexts.
Amount spent so far
Equipment and infrastructure
Training and health care education
Training on microfinance
The implementation of the project allows for an important advocacy activity, aiming mainly at the introduction of policies, capacity building, women empowerment, and improvement of service quality. The outcome was the support and participation of the first Midwifes Conference in Nepal held in September of 2013. We have also forged close links with Planet Finance, sharing their expertise in microfinance through training, evaluation, and advice.
Save women’s life through reproductive health services and financial access
The planned infrastructure has been implemented in each location: Private and hygienic spaces for reproductive health and delivery services are now available and include an environment-friendly medical waste management.
Equipments have now been distributed to health centers including delivery beds, safe delivery kits, kits for the newborn resuscitation as well as hygiene and sterilization kits. Each of these donations have been accompanied by specific training, protocol and guidelines to ensure a proper use of each item.
Ten staff members have been trained as Skilled Birth Attendant. More than 200 men and grandmothers participated to our health education sessions: Being usually the decision makers in the family, it is critical that they understand the importance of ante-natal care and how deliveries by Skilled Birth Attendance make a huge difference. Finally all members of the cooperative have received a traning in microfinance to encourage sustainable access to reproductive care.
Risks and challenges
In many rural Nepalese communities, women and girls have to sleep in the cowshed when they are menstruating: a woman is considered impure and cannot come near the family house and has to be isolated for more than 12 days when she is having her periods.
Delivering is also considered as such: the blood and bodily secretions associated with childbirth are widely viewed as unclean and polluting. As a result, most people are reluctant to help women who require obstetric assistance. In this context, training and maintaining skilled birth attendant capable of providing pre and post natal care in remote areas are a challenge. Educating communities, empowering women, and ensuring more continuity of the health services are our priorities.
"We hope to offer to all women in need a decent, friendly and safe place.... for giving birth." Doctors of the World staff member
Our remaining work will focus on the quality and sustainability of our program as well as continuing to support our different partners. Our hope is to replicate our program in other areas since different reports highlighted the necessity for our program to be implemented at a larger scale.
The forecasted budget has been partially used following the initial proposal. The remaining budget will be entirely used within the end of the year until full completion of our program.
Our project includes an important component of advocacy: We are actively contributing to the public debate, discussions about policy changes, capacity building, women empowerment and service’s quality improvements. We have actively taken part of the new educational program for midwifes in Nepal. As a result, Doctors of the World has participated to the first Midwifes Conference in Nepal, held in September 2013.
Support health centers in Sindhupalchok district, Nepal, provide better care to mothers and newborns through health education, microfinance training and services.
Why we care: In the mountainous Sindhupalchok district, only 5% of births take place in health facilities, compared with the national average of 20%—resulting in a high number of maternal and neonatal deaths.
How we’re solving this: Help 10 health centers train medical personnel, purchase medicine and medical equipment, and provide health and microfinance education.
Doctors of the World supports health centers in the district provide maternal, neonatal and 24-hour emergency obstetric care to an estimated 5,519 women and newborns per year. This project will help Doctors of the World renovate several health centers and purchase equipment and medicines, such as basic emergency obstetric care equipment, clean delivery kits and stretchers. These will be distributed across health facilities so women can access institutional delivery, especially in the case of obstetric emergencies.
Doctors of the World also uses health education and microfinance training to support women in accessing care. Women meet to discuss reproductive health and then participate in training sessions on microfinance, specifically learning how to access funds in case of an obstetric emergency. Patients discuss sexual and reproductive health concerns, including birth preparedness, delivery and post-partum and family planning, with trained Doctors of the World or partner staff and community facilitators.
The microfinance program encourages community involvement and sustainable access to reproductive care. Funding from this project will help train community health workers to provide financial literacy training to center members on issues, such as managing the household budgets and paying for health care expenses. Women in the group all know each other, which makes it easier to discuss sensitive issues, such as household budgets, the burden of disease and taboos like uterus prolapse.
Doctors of the World allocate NR400,000 (approximately $7,400) per cooperative of 400 women so women can start income generating activities. In addition, another fund exists for the sole purpose of interest-free loans for women in need of emergency obstetrical care.
Photo credit: Stéphane Lehr
Doctors of the World is supported by the Kering Foundation, which combats violence against women and promotes their empowerment. Launched in January 2009, the Foundation supports community-based projects and encourages employee involvement to sustain women’s causes around the world. Through four programmes, it supports local and international NGOs as well as social entrepreneurs, helps raise awareness and establishes joint projects with the Kering brands. In 2012, more than 80,000 women benefited from its support in 16 countries. *In line with PPR’s change of name, the PPR Corporate Foundation for Women’s Dignity and Rights will become the Kering Corporate Foundation, subject to approval at the Foundation’s board meeting on 26 June 2013. www.keringfoundation.org @KeringForWomen