Reaching urban poor in providing maternal & child health including SRHS through nurse-midwives led birthing centre
Nurses or midwives if committed to contribute in improving maternal health they can do it. This has been proven by Nepalese nurses, establishing birthing centre in their own initiation and individual financial contribution that provide high quality, affordable health care services to urban poor families in the locality.
About You
Section 1: About You
First Name
Laxmi
Last Name
Tamang
Website
Organization
Aadharbhut Prasuti Sewa Kendra (Free-standing Nurse-midwives led birthing centre)
Country
Nepal
Are you an individual between the ages of 18 and 35 who would like to apply for a nine month Young Champions Program mentored by an Ashoka Fellow?
No
Section 2: About Your Organization
Organization Name
Aadharbhut Prasuti Sewa Kendra (Free-standing Nurse-midwives led birthing centre)
Organization Website
Organization Phone
977-1-4272326
Organization Address
PO Box 8975, EPC 2946, Kalanki, Kathmandu
Organization Country
Nepal
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Your idea
Name Your Project
Reaching urban poor in providing maternal & child health including SRHS through nurse-midwives led birthing centre
Country your work focuses on
Nepal
Describe Your Idea
Nurses or midwives if committed to contribute in improving maternal health they can do it. This has been proven by Nepalese nurses, establishing birthing centre in their own initiation and individual financial contribution that provide high quality, affordable health care services to urban poor families in the locality.
Website URL
Innovation
What makes your idea unique?
Since this is the first and only nurse-midwives led free-standing privatly run birthing centre in Nepal that provides 24 hours in a day, 7-days a week free maternity care services for healthy pregnancies and healthy mothers this initiative is itself innovative because this is the first and only initiative taken by Nepalese nurses in a low resource setting, where they have never ever taken such a step independently.
What makes also my idea unique is that nurses work together to take care of the mothers, youth and children, this will only make them stronger as a team. Since our centre is managed and staffed by nurses they are there during the whole pregnancy, encourage the mother to do at least four check ups during the pregnancy and assistance mother for their normal deliveries. They provide wholistic care to mothers and babies.
Do you have a patent for this idea?
Impact
This Entry is about (Issues)
What impact have you had?
To date we have served more than 10000 women and children. Urban poor families are benefitting by accessing 24 hours a day, 7-days a week SRH and child health services. Pregnant and labouring women have been empowered and feel confident to take care for their health. Couples who wish to give normal birth in a home-like environment under the direct supervision of skilled birth attendents and in the presence of spouse or relatives are getting place to do so. Women are getting women-centered care in a home-like relaxed and friendly environment for the birth of their baby. Besides, student nurses are getting exposure for their clinical placement in the nurse-midwives led birthing centre from where they are learning evidence-based care and also getting confident to take such initiative in their own in the future in the partnership with colleagues. Additionally, nursing students who are waiting for your final results are getting place to get hands-on clinical practice and exposure under direct supervision of senior nurse-midwives.
Problem
In a city like Kathmandu valley where majority of the rural people have been migrated for the employment have limited access to maternal and reproductive health services. Therefore, they are forced to go to nearby pharmacy retailers for their health problems and family planning services. There are no health health facilities serving urban poor families to provide such services. Surprisingly, still many women are giving birth at home in their own without the assistance of skilled birth attendents in unsafe environment.
Actions
Establishment of free-standing birthing centre managed and staffed by nurse-midwives in the strategic location where mostly urban poor are residing.
Provides following SRH and child health services:
1. Family Planning and Gynecology:
- Contraceptive counseling and methods
- Pap smears
- HIV and STI counseling, testing and management
- Obs/Gynae consultation
- Comprehensive Abortion Care
- Youth Friendly Services
2. Maternity:
- Prenatal check-up and counseling
- Skilled nurse-midwife attended births in a home-like environment accompanied by husband or relative
- Linkages for complicated deliveries at the tertiary level hospitals
- Breast-feeding assistance
- Post partum and follow-up care including home-visits
3. Child Health:
- Newborn care
- Immunization
- Integrated Management of Childhood Illness
- Growth Monitoring and nutrition education
4. Other Services Available:
- Ultrasounds
- Pharmacy
- Laboratory
- Biannual Free Women’s Health Camp
- Home visits
- Community awareness raising activities
- Minor Illness treatment and management
- Nursing student clinical placement
- Volunteering opportunities for newly graduate nursing stude
Results
Urban poor women, youth, and young families have access to high quality and affordable maternal, child including sexual and reproductive health care services any time as per their convinence. Women are aware of their reproductive health rights. Women and adolescent are educated and counselled for the prevention and promotion of their including their children and family health. Childbearing Couples have access to home-like relaxed and friendly environment for the birth of their baby under direct supervision and assistance of skilled birth attendents. Nursing colleges are getting clinical placement site for exposure of their students. Periurban women are benefitting from biannual free women's health camps.
What will it take for your project to be successful over the next three years? Please address each year separately, if possible.
Our strenthens such as good coordination and collaboration with Ministry of Health & Population (MoHP); goodwill and recognition from the MoHP; competent team members; and committed founder chairperson and managing director to do good and better in the field of RH/Midwifery service/practice in the country will take our initiative to be successful over the next three years.
Our organisation future plan such as establishing a training site for FP/SBA), playing key role in contributing to produce professional midwives program in accordance with the National SBA Policy, 2006 Long term (Pre-service) Measures in contributing to achieving MDG 4 & 5; and expansion of its services are also the initiative that our organisation is planning to carried out over the next three years.
What would prevent your project from being a success?
Financial matter is preventing our project from being a success. This is because initially each of the group member has contributed NRs. 100,000/- from their own pocket. They were quite committed and active but as the time passes they are becoming inactive because they are not getting any recognition for time contribution which they are providing for shift duties. Little revenue generated from the services is not adequate even to pay staff salaries, house rent and other operational costs. This is also because of the government policy to pay 5% tax in the health service. Financial matter has also prevented us for the expansion of our services. It has also hindering to maintain solidarity among members.
How many people will your project serve annually?
More than 10,000
What is the average monthly household income in your target community, in US Dollars?
$50 - 100
Does your project seek to have an impact on public policy?
Yes
Sustainability
What stage is your project in?
Operating for 1‐5 years
Is your organization a
For‐profit
Is your initiative connected to an established organization?
Yes
If yes, provide organization name.
District Public Health Office-an government health institution
How long has this organization been operating?
1‐5 years
Does your organization have a Board of Directors or an Advisory Board?
Yes
Does your organization have a non-monetary partnerships with NGOs?
Yes
Does your organization have a non-monetary partnerships with businesses?
Yes
Does your organization have a non-monetary partnerships with government?
Yes
Please tell us more about how these partnerships are critical to the success of your innovation.
Our organisation has signed MoU with with the Kathmandu Model Hospital managed by Phect (NGO)to make referral for cases who need high level of management and care that cannot be managed from our centre. Similar kind of partnership we've with the Population Service International (INGO) but in this case we provide platform to them to provide IUCD services to women around the locality and our centre manage the referral cases if complications arise to those women. Likewise, we've partnership with Human Development Resource Institute (NGO) for the on-the-job training of their nursing students. Our organisation has formal corresponded with B & B Medical College Pvt Ltd (private) for the clinical placement of their nursing students in our centre. Our organisation has very good coordination and collaboration with the District Health Office, Kathmandu (Government)from where we bring vaccines routine immunisation and family planning devices in a monthly basis to run FP/MCH clinic and we send report to them in a monthly basis. Besides, our organisation has signed MoU with the District Health Office last year on September to provide maternity service free of cost as per the government policy.
What are the three most important actions needed to grow your initiative or organization?
The three most improtant actions that are needed to grow our initiative include institutional development to make financially sustainalbe and expansion of its services; maintaining solidarity among members; and maintaining professional standard of quality of care and services.
The Story
What was the defining moment that you led to this innovation?
In April 2007, after I returned from completing my Master of Public Health degree in Australia, I started to work as a lecturer in a private health science college that offered a bachelor of public health and a nursing program. I noticed that health education has been privatized and the fees charged by such colleges are extremely high. These colleges are mainly established by business people to generate money; therefore, quality of education is not the priority. Students would graduate having had academic experience with limited faculty members and poor practical exposure in clinical and field placement. This worried me, as I thought about how these students would be able to compete with other candidates to find jobs after graduation. On the other hand, faculty members were low paid and expected to work longer hours with no additional benefits. As a result, I was not satisfied with what I was doing and felt exploited because I thought I am playing a major role in ruining the future of the students.
Besides, there were other factors that led to the formation of the group. Firstly, discussing with colleagues we realized that the time is right to promote the concept of a natural birthing centre led by nurses. This is because that the Government of Nepal had developed a policy to produce skilled birth attendants to mobilize in improving maternal and neonatal health status in the country to meet the Millennium Development Goals. Despite being educated professional women, nurses had never done any sort of initiative independently or on their own. Secondly, we realized that the private sector nursing colleges are producing nurses in large numbers, but the quality of their education is lacking due to limited clinical placement in hospitals, especially for midwifery. Those nurses who had graduated from these colleges usually had to work as volunteers in private hospitals for a year to obtain the experience needed to get a job. We believed that these hospitals are exploiting our juniors because they did not even pay a minimal allowance, even though the students’ parents had invested a lot of money in their study in the belief that they would get a good job after their graduation. Thirdly, a city like Kathmandu has too many private hospitals—none of which serve poor people. in the public hospital women are not satified because of low quality care.
Tell us about the social innovator behind this idea.
I am registered nurse with public health background committed to improving women's health due to the dismal conditions and low maternal health indicators in the country. I am committed to promoting independent midwifery practice in Nepal, raising the standards of nursing and midwifery education, and working to ensure safe motherhood, reproductive health and women's empowerment.
How did you first hear about Changemakers?
Web Search (e.g., Google or Yahoo)
If through another, please provide the name of the organization or company
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 | 137 weeks ago Nataly Arlingston said: I guess this is one of the best methods to help that exist. I believe that everybody agrees that if you want a person to eat fish often ... about this Competition Entry. - read more > |
| 163 weeks ago Laxmi Tamang said: Dear Jessica, Greetings from Nepal. Nice to receive your message with your supportive thoughts and an interest of visiting and ... about this Competition Entry. - read more > |
| 163 weeks ago Laxmi Tamang said: Dear Joanna, Thank you for your interest in our initiative and queries relating to this. Telling about my background I hold a ... about this Competition Entry. - read more > |
| 163 weeks ago Jessica Christen said: Hello Laxmi, My name is Jessica Christen. I am a student of the National Midwifery Institute in the USA and have been apprenticing ... about this Competition Entry. - read more > |
| 166 weeks ago Joanna Blonska said: Hello Laxmi Tamang, I am impressed by the work you are doing in Nepal. I would to know more about your personal background and ... about this Competition Entry. - read more > |
| 169 weeks ago Laxmi Tamang said: Dear Naveen, Thank you for your queries relating to the financial sustainability of our organization and whether or not we are ... about this Competition Entry. - read more > |
| 171 weeks ago Naveen Shakir said: Thanks for a great entry! Your initiative has clearly been quite successful, and seems like a great way to increase access to health ... about this Competition Entry. - read more > |
| 173 weeks ago Nima Tamang said: There are many non government organization in Nepal exist for the sake of human welfare. As she has mentioned they are simply a parasite ... about this Competition Entry. - read more > |
| 173 weeks ago Laxmi Tamang said: Dear Jake, From the very beginning of our initiative we were quite aware about the financial sustainability of our organization. ... about this Competition Entry. - read more > |
| 173 weeks ago Jake Miller said: I'm curious as to how you are currently funded. You already mentioned funding as one of your major problems. How do you plan to overcome ... about this Competition Entry. - read more > |
