sanishah

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Safemotherhood

• Presented by
• Shashibhusan shah gond
• Generalmedicine

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History Safe motherhood 1987- Kenya, Nairobi
1994 -Initiation in Nepal 1997-Nepal safe
motherhood program 1997-2017 The main thrust
of national safe motherhood program is to reduce
maternal and neonatal mortality by addressing the
high rates of death and disablility caused by
the complication and childbirth
INTRODUCTION
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GOALS

• To reduce maternal and neonatal morbidity
  mortality
• To improve maternala neonatal health through a
  comprehensive approach of providing preventing,
  promotive, curative and rehabilitative healthcare
  activities.
• Improve maternal neonatal health by dressing
  available factors that cause death during
  pregnancy, child birth and postpartum period.

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OBJECTIVES

• Improve quality and increase access to family
  planning and maternal health care services .
• Educate couples to ensure they have the best
  chance for a wanted and safe pregnancy.

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STRATEGIES

• 1. Promoting intersectoral collaboration for
  safe motherhood at central, regional, district
  community level i.e. between sectors like
  healtheducation, and social welfare ,legal and
  local development
• 2. Promote research on safe motherhood to
  contribute to improved planning , higher quality
  services, and more cost-effective interventions
• 3. Supporting activities that raise the status
  of women in society

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Activites

• Birth Preparedness Package and community level
  maternal and newborn health.
• Rural Ultrasound Program.
• Reproductive health morbidity prevention and
  management program.
• Emergency referral funds.
• Safe abortion services.
• Nyano Jhola Program.
• Aama and Newborn Program.
• Safe Motherhood Program i.e. ANC visit

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Activities

• 1. Birth Preparedness Package and community level
  maternal and newborn health.
• Distributed the matri suraksha chakki
  (misoprostol) to prevent postpartum haemorrhage
  (PPH) in home deliveries.
• For home deliveries, three misoprostol tablets
  (600 mcg) are handed over to pregnant women to
  take immediately after delivery and before the
  placenta is expelled.
• Forty-two districts were implementing the
  program in 2072/73 and FHD has budgeted to scale
  the program up to three more districts in
  2073/2074

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ULTRA SOUND

•  timely identification of pregnant women with
  risks of obstetric complication to refer to
  comprehensive emergency obstetric and neonatal
  care (CEONC) centres.
• This program is being implemented in the 11
  remote districts of Mugu, Dhading, Darchula,
  Sindhupalchowk, Solukhumbu, Bajura Bajhang,
  Achham, Dhankuta, Humla, and Baitadi. Ands one
  another district is add in 2074 sinduli
• Eighteen(Trained nurse) SBAs received three weeks
  training on the antenatal ultrasonography in
  2072/2073

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Reproductive health morbidity prevention and
management program.
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Emergency referral funds.

• It is estimated that 15 of pregnant women will
  develop serious complication during their
  pregnancies and deliveries 5-10 of them will
  need caesarean section deliveries (WH0 2015).
• A total of 7,500,000 Rupees was allocated to six
  provinces to support women when needed.
• Additional 12,000,000 Rupees was allocated for
  the hospitals in the districts through 7 province
  to support transport fares women who could not
  afford referral to higher facility (nearby CEONC
  facilities).

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SAFE ABORTION SERVICESo

• To make safe abortion services available,
  accessible and affordable to all women with
  unwanted pregnancies.
• 4 key components of comprehensive abortion care
  as
• Pre and post counselling on safe abortion methods
  and post-abortion contraceptive methods
• Termination of pregnancies as per the national
  protocol
• Diagnosis treatment of existing reproductive
  tract infections
• Provide contraceptive methods as per informed
  choice and follow-up for post-abortion
  complication management

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NYANO JHOLA PROGRAMME-

• Launched in 2069.
• To protect newborns from hypothermia and
  infections.
• 2 set of clothes (Bhoto , daura napkin cap).
• 1 set wrapper, mat for baby1 gown for mother.

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AAMA AND THE NEW BORN PROGRAM

• The Government of Nepal introduced demand side
  intervention in maternal health with the aim of
  encouraging institutional delivery.
• The Maternity Incentive Scheme, launched in 2005
  and designed to share the cost of transportation
  to health facility.
• In 2009, in addition to transport incentive user
  fees were removed from all types of delivery
  care, known as the Aama Program.
• In 2012, 4 ANC incentives program(introduced in
  2009) was merged with Aama Program.
• In FY 2073/74, the free new born care program
  (introduced in FY 2072/73) has been merged to the
  Aama program.

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• Aama program and has the following provisions.
• For women delivering their babies in health
  institutions
• Transport incentive for institutional delivery
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  NPR 3,000 in mountains districts,
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  NPR 2,000 in hills districts
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  NPR 1000 in Terai districts
• Incentive for 4 ANC visits
• NPR 800 to women on completion of four ANC
  visits.
• Free institutional delivery services
• A payment to health facilities for providing free
  delivery care.
• For a normal
  delivery NPR 1,000 or 1,500
• For complicated
  deliveries NPR 3,000For C-sections (surgery) NPR
  7,000
• Anti-D administration for RH -ve mothers NPR
  5,000.
• Laparotomy NPR 7,000 to both public and
  private facilities.

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• Incentives to health service provider
• For deliveries A payment of NPR 300 to health
  workers for attending all types of deliveries to
  be arranged from health facility reimbursement
  amounts
• Newborn Care Program Provision
• Free sick new born care
• a. For sick newborns
• 4 different types of package (Package 0, Package
  A, B, and Package C) for sick newborns case
  management.
• Reimbursed to health facility
• The cost of package of care include 0 Cost for
  Packages 0, and NPR 1000, NRP 2000 and NRP 5000
  for package A, B and C respectively.
• maximum of NPR 8,000 (packages ABC), depending
  on medicines, diagnostic and treatment services
  provided.
• b. Incentives to health service provider A
  payment of NPR 300 to health workers for
  providing all forms of packaged services to be
  arranged from health facility reimbursement
  amounts..

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Status of safemotherhood programme

• 1.Antenal care
• WHO recommends a minimum of four antenatal check
  ups at regular interval of all
• Pregnant women (at the fourth , sixth, eighth and
  ninth months of pregnancy ).
• Status in f

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• Nepals Safe Motherhood and Newborn Health (SMNH)
  Road Map 2030 aims to ensure a healthy life for,
  and the well-being of, all mothers and newborns.
• The Road Map is aligned with the Sustainable
  Development Goals (SDGs) to reduce the current
  Maternal Mortality Ratio (MMR) from 239 to 70
  deaths per 100,000 live births (or at least
  two-thirds from the 2010 baseline) by 2030.
• It also aims to reduce the Newborn Mortality Rate
  (NMR) from the current 21 to less than 12 deaths
  per 1,000 live births, and
• the stillbirth rate from the current 18 to below
  12.5 deaths per 1,000 live births by 2030.

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REFERANCES

• ANNUAL HEALTH REPORT 2074/75
• NATIONAL HEALTH PROGRAM

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