The document provides an overview of the management of safe motherhood and newborn health services in Nepal. It discusses the goals and strategies of the Safe Motherhood and Newborn Health Program, which aims to reduce maternal and neonatal mortality through preventative activities and addressing delays in seeking and receiving care. Major activities outlined include birth preparedness, rural ultrasound programs, reproductive health services, expanding health facilities, training health workers, and demand-side financing incentives for institutional deliveries. It also reviews the program's status, management perspectives using the POSDCORB framework, and identifies issues such as high maternal mortality and the need to establish effective referral mechanisms.
The document outlines Nepal's Safe Motherhood Programme which aims to reduce maternal and neonatal morbidity and mortality through various strategies and activities. The major strategies include promoting birth preparedness, expanding 24-hour birthing facilities, and emergency obstetric care services. Key activities involve community-level maternal and newborn interventions, expanding service delivery sites, emergency referral funds, and programs to provide free delivery services and newborn supplies. The goals are to address delays in seeking and receiving care and improve access to institutional deliveries and emergency obstetric services.
Safe Motherhood Program in Nepal: Challenges and Way ForwardKusumsheela Bhatta
The safe motherhood programme is one of the priority programme of Nepal. The goal of the National Safe Motherhood Program is to reduce maternal and neonatal morbidity and mortality and to improve the maternal and neonatal health through preventive and promotive activities as well as by addressing avoidable factors that cause death during pregnancy, childbirth and postpartum period. This presentation incorporates historical context, introduction, major achievements, actors, what Went Well, what didn’t go well, limitations, challenges, way forward of Safe Motherhood Program in Nepal.
Swot analysis of safe motherhood program of Nepalsirjana Tiwari
The document provides an overview of Nepal's Safe Motherhood and Newborn Health Program, including its goals, strategies, activities and management. Some key points:
- The program aims to reduce maternal and neonatal morbidity and mortality through preventative activities and addressing factors that cause death during pregnancy, childbirth and postpartum.
- Major strategies include promoting birth preparedness, the Aama program to promote antenatal checkups and institutional delivery, and expanding emergency obstetric services.
- Key activities include distribution of birth preparedness packages, rural ultrasound programs, expansion of birthing centers and emergency obstetric care sites, and training of skilled birth attendants.
- The program is managed through planning
Health education and promotion in nepalAmrit Dangi
This document discusses the history of health promotion and education in Nepal. It outlines key initiatives from ancient times through the modern era. Some of the major developments include the use of Ayurveda practices in ancient times, plague elimination efforts by missionaries in medieval times, the introduction of vaccination and sanitation campaigns in the Rana regime, and the establishment of the National Health Education Information and Communication Centre in 1993 to coordinate health promotion programs. The document shows how health promotion has increasingly become a priority and systematic part of national health plans and policies over time in Nepal.
Nepal legalized abortion in 2002 and further expanded access through its 2018 law. The law allows abortion up to 12 weeks with consent, up to 28 weeks in cases of rape/incest or health risks, and the government aims to make safe abortion services widely available. However, challenges remain due to stigma and some sex-selective abortions. National policies focus on training health workers and expanding comprehensive abortion care, including counseling, at health facilities across the country.
The National Health Policy of 1991 in Nepal had the objective of extending primary health care services to rural populations. It outlined 14 areas to achieve this, including preventive services like immunization and MCH, promotive services like health education, curative services through a referral system, strengthening primary health care, and developing human resources. However, a critical review found it lacked clear strategies for equity, collaboration, and community participation. While it targeted rural areas, there was no strategy for marginalized groups' access. Collaboration and referral mechanisms were also not clearly defined. Community participation was mentioned but ignored beneficiaries' involvement in services.
Unit 3.2 national safe motherhood policy 1998chetraj pandit
The 1998 Safe Motherhood Policy in Nepal aimed to reduce maternal mortality and morbidity. Its objectives were to increase access, availability, and utilization of maternal health services; strengthen the capacity of maternal healthcare providers; strengthen referral services for maternity care; raise public awareness of maternal health and safe motherhood; and improve the legal and socioeconomic status of women. The strategies included promoting inter-sectoral collaboration, strengthening and expanding delivery services by skilled birth attendants and emergency obstetric care at all levels, supporting activities to raise the status of women, and promoting research on safe motherhood.
The document summarizes Nepal's family planning program. The main objectives are to improve health outcomes for mothers and children by increasing access to quality family planning services, especially for rural and marginalized groups. Key activities include providing various contraceptive methods through both institutions and mobile clinics. While contraceptive use and access have increased over time, challenges remain such as high unmet need and an overreliance on emergency contraception and abortion. Recommendations focus on strengthening access to long-acting reversible contraceptives and services for adolescents.
The document outlines Nepal's Safe Motherhood Programme which aims to reduce maternal and neonatal morbidity and mortality through various strategies and activities. The major strategies include promoting birth preparedness, expanding 24-hour birthing facilities, and emergency obstetric care services. Key activities involve community-level maternal and newborn interventions, expanding service delivery sites, emergency referral funds, and programs to provide free delivery services and newborn supplies. The goals are to address delays in seeking and receiving care and improve access to institutional deliveries and emergency obstetric services.
Safe Motherhood Program in Nepal: Challenges and Way ForwardKusumsheela Bhatta
The safe motherhood programme is one of the priority programme of Nepal. The goal of the National Safe Motherhood Program is to reduce maternal and neonatal morbidity and mortality and to improve the maternal and neonatal health through preventive and promotive activities as well as by addressing avoidable factors that cause death during pregnancy, childbirth and postpartum period. This presentation incorporates historical context, introduction, major achievements, actors, what Went Well, what didn’t go well, limitations, challenges, way forward of Safe Motherhood Program in Nepal.
Swot analysis of safe motherhood program of Nepalsirjana Tiwari
The document provides an overview of Nepal's Safe Motherhood and Newborn Health Program, including its goals, strategies, activities and management. Some key points:
- The program aims to reduce maternal and neonatal morbidity and mortality through preventative activities and addressing factors that cause death during pregnancy, childbirth and postpartum.
- Major strategies include promoting birth preparedness, the Aama program to promote antenatal checkups and institutional delivery, and expanding emergency obstetric services.
- Key activities include distribution of birth preparedness packages, rural ultrasound programs, expansion of birthing centers and emergency obstetric care sites, and training of skilled birth attendants.
- The program is managed through planning
Health education and promotion in nepalAmrit Dangi
This document discusses the history of health promotion and education in Nepal. It outlines key initiatives from ancient times through the modern era. Some of the major developments include the use of Ayurveda practices in ancient times, plague elimination efforts by missionaries in medieval times, the introduction of vaccination and sanitation campaigns in the Rana regime, and the establishment of the National Health Education Information and Communication Centre in 1993 to coordinate health promotion programs. The document shows how health promotion has increasingly become a priority and systematic part of national health plans and policies over time in Nepal.
Nepal legalized abortion in 2002 and further expanded access through its 2018 law. The law allows abortion up to 12 weeks with consent, up to 28 weeks in cases of rape/incest or health risks, and the government aims to make safe abortion services widely available. However, challenges remain due to stigma and some sex-selective abortions. National policies focus on training health workers and expanding comprehensive abortion care, including counseling, at health facilities across the country.
The National Health Policy of 1991 in Nepal had the objective of extending primary health care services to rural populations. It outlined 14 areas to achieve this, including preventive services like immunization and MCH, promotive services like health education, curative services through a referral system, strengthening primary health care, and developing human resources. However, a critical review found it lacked clear strategies for equity, collaboration, and community participation. While it targeted rural areas, there was no strategy for marginalized groups' access. Collaboration and referral mechanisms were also not clearly defined. Community participation was mentioned but ignored beneficiaries' involvement in services.
Unit 3.2 national safe motherhood policy 1998chetraj pandit
The 1998 Safe Motherhood Policy in Nepal aimed to reduce maternal mortality and morbidity. Its objectives were to increase access, availability, and utilization of maternal health services; strengthen the capacity of maternal healthcare providers; strengthen referral services for maternity care; raise public awareness of maternal health and safe motherhood; and improve the legal and socioeconomic status of women. The strategies included promoting inter-sectoral collaboration, strengthening and expanding delivery services by skilled birth attendants and emergency obstetric care at all levels, supporting activities to raise the status of women, and promoting research on safe motherhood.
The document summarizes Nepal's family planning program. The main objectives are to improve health outcomes for mothers and children by increasing access to quality family planning services, especially for rural and marginalized groups. Key activities include providing various contraceptive methods through both institutions and mobile clinics. While contraceptive use and access have increased over time, challenges remain such as high unmet need and an overreliance on emergency contraception and abortion. Recommendations focus on strengthening access to long-acting reversible contraceptives and services for adolescents.
Adolescent sexual and reproductive health (ASRH) in Nepal Public Health
1) The document outlines Nepal's Adolescent Sexual and Reproductive Health (ASRH) strategy, which aims to promote the health of adolescents aged 10-19.
2) Key achievements include expanding ASRH services to 75 of 77 districts, establishing 6 ASRH clinical training sites, and training over 1,700 health workers.
3) Challenges include high rates of early marriage, low contraceptive use among adolescents, and a need for more trained staff and resources for the ASRH program.
This document summarizes the seminar presented by Rushikesh B Pawar on planning process. It discusses various definitions and concepts of planning including national health planning, national development planning, and policy. It outlines the purposes and elements of planning process including objectives, policies, programs, schedules and budget. The document then discusses various committees related to health planning in India including the Bhore Committee, Mudaliar Committee, Chadah Committee, Mukerji Committee, Jungalwala Committee, Kartar Singh Committee and Shrivastav Committee. It also discusses the National Health Policy 2002 and achievements in health indicators from 1951 to 2004 in India.
The document discusses intersectoral coordination for health, which involves coordinating health initiatives with other sectors that impact health, like education, agriculture, rural development, etc. It outlines key principles like development influencing health and equity. Areas of coordination include nutrition, water supply, sanitation, and maternal/child health. Coordination mechanisms involve forming committees to jointly plan initiatives across sectors. Benefits are achieving goals no single sector can alone and preventing overall welfare losses from uncoordinated policies.
The National Neonatal Strategy aims to improve newborn health and survival in Nepal. It was developed based on a situation analysis and expert recommendations. The goals are to increase adoption of healthy newborn care practices and strengthen neonatal health services at all levels. Key interventions include developing policies and guidelines, behavior change communication, strengthening service delivery through training health workers and improving facilities, better program management, and conducting operational research. The strategy provides an evidence-based framework to guide stakeholders in improving neonatal outcomes in Nepal.
The CB-IMNCI program in Nepal aims to improve newborn and child survival through integrated management of neonatal and childhood illnesses in communities. It was established in 2015 by merging the CB-IMCI and CB-NCP programs. The CB-IMNCI program trains frontline health workers and volunteers to provide essential newborn care, manage childhood illnesses like pneumonia and diarrhea, and make timely referrals. It aims to reduce under-five mortality and neonatal mortality by expanding services to 90% of the population by 2020. Monitoring indicators include institutional delivery rates, newborn care practices, and treatment of childhood illnesses.
Neonatal Health in Nepal _ Saroj Rimal.pptxsarojrimal7
The document describes about the History, trends and programs to improves the neonatal health of nepal. It will helps to know and understand the current programs and what was done before for the health of neonates and childrens in nepal. Mostly used for Public health, Nursing and Medical students. The document is developed on 2023 so, the policies and programs after 2023 was not encorporated in this document.
Review of current health service planning in Nepal from province to local levelMohammad Aslam Shaiekh
This document summarizes a review of health service planning in Nepal from the provincial to local levels. It describes the new federal system of government in Nepal with three tiers (federal, provincial, local). At the local level in Pokhara Metropolitan City, the findings show 41 health facilities serving 479,000 people. A top-down and bottom-up approach is used for health program and budget planning. At the provincial level, the Gandaki Province health directorate provides technical support to 11 districts. The challenges of implementing health planning under federalism include coordination between levels of government and building capacity of newly elected local bodies. Recommendations focus on collaboration, clarifying roles, training, and strengthening infrastructure and resources at the
National health education, information and communication centerShisam Neupane
Established under MOHP in 1993, NHEICC is responsible for planning,Implementing, monitoring and evaluating awareness raising, information, education and communication program related to health programmes and services.
The Nepal Health Sector Strategy (NHSS) 2015-2020 provides strategic guidance for the health sector over five years. Its goal is to improve health status through accountable and equitable health services. NHSS outlines nine outcomes, including rebuilding health systems and improving quality of care. It identifies key outputs needed to achieve each outcome, along with interventions, indicators, targets, data sources, and timelines to monitor progress in strengthening Nepal's health sector.
The document summarizes Nepal's Community Based Integrated Management of Newborn Care (Neonatal care) and Childhood Illness (CB-IMNCI) program. The key points are:
[1] CB-IMNCI aims to reduce neonatal and under-5 mortality by promoting essential newborn care, managing major causes of illness in newborns and children, and improving access to health services.
[2] It integrates newborn care programs with childhood illness management. Major interventions include birth preparedness, essential newborn care, treatment of neonatal sepsis, and management of childhood illnesses like pneumonia and diarrhea.
[3] The goal is to achieve targets for reducing under-5 and
This document summarizes the child health program in Nepal. It discusses the main medical causes of infant mortality and morbidity, including low birth weight, respiratory infections, diarrhea, and malnutrition. It then outlines Nepal's national immunization program, which aims to increase vaccination coverage and prevent diseases like polio, measles, and tetanus. The program is guided by national health strategies and goals to reduce child mortality and morbidity from vaccine-preventable illnesses. Key activities discussed include vaccinator training, polio campaigns, and integrated disease surveillance.
Public health intervention for newborn in nepalDeepakPandey315
This document summarizes public health interventions for newborns in Nepal. It first provides background on newborns being highest risk in the first 28 days of life. It then outlines the main causes of newborn death in Nepal. The interventions discussed include immunization programs, the "Aama Surakshya" program providing transportation incentives for institutional delivery, newborn care programs, the "Nyano Jhola" program providing newborn clothes/gowns, the Navi Malam umbilical cord chlorhexidine program, nutrition programs, and the CBIMNCI program integrating newborn and child health interventions.
Nepal Health Sector Program Implementation Plan II (NHSP-IP2)Dip Narayan Thakur
The document summarizes Nepal's Health Sector Implementation Plan II (NHSP-IP II). NHSP-IP II aimed to strengthen Nepal's health system from 2010-2015 by improving access, equity, and utilization of essential health services. It reviewed achievements and shortcomings of NHSP-IP I and outlined NHSP-IP II's vision, goals, strategies, and financing plans. Key points included reducing morbidity and mortality through accessible, affordable, quality care; addressing sustainability issues in health financing; and achieving greater efficiency through health systems strengthening. Progress was made in areas like immunization and maternal health, but challenges remained around nutrition, non-communicable diseases, and equity gaps.
Nepal began its malaria control program in 1954 with support from the United States, launching an eradication program in 1958. The program shifted to control in 1978 and was revamped in 1998 under the WHO's Roll Back Malaria initiative. Nepal has since adopted a long-term elimination strategy with the goal of being malaria-free by 2026. The program is managed through Nepal's Epidemiology and Disease Control Division and focuses on surveillance, diagnosis and treatment, vector control, and community education to achieve elimination.
National Health Policy of Nepal 2076 (ENGLISH)BPKIHS
The National Health Policy of Nepal-2076 outlines the country's vision, mission, goals, and policies for health. Its key points are:
The vision is for aware and healthy citizens. The mission is to ensure citizens' right to health through optimal resource use and cooperation. Goals include creating opportunities for all citizens to access health. There are 25 policy areas with over 100 strategies to restructure the health system according to the federal system and ensure universal health coverage through various programs and services. The policy addresses issues like non-communicable diseases, health workforce and services, and takes a more integrated approach than previous policies.
Comprehensive Field Practice (CFP) : District Health Service Management Mohammad Aslam Shaiekh
The document summarizes the activities and learnings of a group of public health students during their 30-day field placement in Surkhet District, Nepal. The group conducted various assessments of the district's health management system including a secondary data review, critical analysis using SWOT, an epidemiological study on major health issues, and a mini action project on plastic waste reduction. Key findings included gaps in safe motherhood services, increasing HIV trends, and issues with logistics management and data reporting. The placement helped the students gain important academic and management skills applicable to their public health careers.
Primary health care outreach clinic and EPI meeenamu
The document discusses Nepal's Primary Health Care Outreach (PHC/ORC) program and National Immunization Program (Expanded Program on Immunization).
The PHC/ORC program aims to improve access to basic health services for rural households through monthly outreach clinics within half an hour's walk of populations. Services include safe motherhood/newborn care, family planning, and child health. In 2075/76, the program served 2.8 million people through 138,125 clinics.
Nepal's immunization program started in 1974 and provides vaccines to children and mothers. It has helped reduce mortality from vaccine-preventable diseases. The program initially provided BCG and DPT in 3 districts and has
The document discusses disease control strategies in Nepal as outlined in the National Health Policy 2071. It identifies the major infectious diseases affecting Nepal, including tuberculosis, HIV/AIDS, malaria, and kala-azar. It also outlines strategies to control these diseases, such as expanding DOTS and ART programs, insecticide-treated bed nets for malaria, and surveillance networks. Some of the key challenges faced in disease control are cross-border disease transmission and strengthening control initiatives for diarrhea, respiratory illnesses and other infectious diseases.
The document discusses Nepal's family planning program. The main points are:
1) Family planning is a priority in Nepal to improve health outcomes and economic development. It aims to ensure individuals can fulfill reproductive needs through informed choice of contraceptive methods.
2) The government, NGOs, and private sector provide a range of temporary and permanent family planning methods through health facilities. Community health volunteers also provide information and some methods.
3) National policies emphasize increasing access, integrating services, and engaging both males and females in planning their families to improve their quality of life.
The document summarizes Nepal's Safe Motherhood program. It describes the program's goals of reducing maternal and neonatal mortality and improving health. Major activities include promoting birth preparedness and emergency funds, expanding skilled birth attendants and emergency obstetric care, managing reproductive health issues, expanding service sites, and programs like Aama that provide incentives for institutional delivery. The program aims to make quality maternal care accessible to all women through these various community-based and facility-based strategies.
The document summarizes Nepal's Safe Motherhood program, which aims to reduce maternal and neonatal mortality. It outlines the program's goals and pillars, including initiatives to address the three delays in seeking, reaching, and receiving care. Key activities include expanding 24/7 birthing facilities, emergency transport funds, ultrasound programs, and training community health workers. The program provides incentives for institutional deliveries, antenatal care, and newborn care through the Aama program.
Adolescent sexual and reproductive health (ASRH) in Nepal Public Health
1) The document outlines Nepal's Adolescent Sexual and Reproductive Health (ASRH) strategy, which aims to promote the health of adolescents aged 10-19.
2) Key achievements include expanding ASRH services to 75 of 77 districts, establishing 6 ASRH clinical training sites, and training over 1,700 health workers.
3) Challenges include high rates of early marriage, low contraceptive use among adolescents, and a need for more trained staff and resources for the ASRH program.
This document summarizes the seminar presented by Rushikesh B Pawar on planning process. It discusses various definitions and concepts of planning including national health planning, national development planning, and policy. It outlines the purposes and elements of planning process including objectives, policies, programs, schedules and budget. The document then discusses various committees related to health planning in India including the Bhore Committee, Mudaliar Committee, Chadah Committee, Mukerji Committee, Jungalwala Committee, Kartar Singh Committee and Shrivastav Committee. It also discusses the National Health Policy 2002 and achievements in health indicators from 1951 to 2004 in India.
The document discusses intersectoral coordination for health, which involves coordinating health initiatives with other sectors that impact health, like education, agriculture, rural development, etc. It outlines key principles like development influencing health and equity. Areas of coordination include nutrition, water supply, sanitation, and maternal/child health. Coordination mechanisms involve forming committees to jointly plan initiatives across sectors. Benefits are achieving goals no single sector can alone and preventing overall welfare losses from uncoordinated policies.
The National Neonatal Strategy aims to improve newborn health and survival in Nepal. It was developed based on a situation analysis and expert recommendations. The goals are to increase adoption of healthy newborn care practices and strengthen neonatal health services at all levels. Key interventions include developing policies and guidelines, behavior change communication, strengthening service delivery through training health workers and improving facilities, better program management, and conducting operational research. The strategy provides an evidence-based framework to guide stakeholders in improving neonatal outcomes in Nepal.
The CB-IMNCI program in Nepal aims to improve newborn and child survival through integrated management of neonatal and childhood illnesses in communities. It was established in 2015 by merging the CB-IMCI and CB-NCP programs. The CB-IMNCI program trains frontline health workers and volunteers to provide essential newborn care, manage childhood illnesses like pneumonia and diarrhea, and make timely referrals. It aims to reduce under-five mortality and neonatal mortality by expanding services to 90% of the population by 2020. Monitoring indicators include institutional delivery rates, newborn care practices, and treatment of childhood illnesses.
Neonatal Health in Nepal _ Saroj Rimal.pptxsarojrimal7
The document describes about the History, trends and programs to improves the neonatal health of nepal. It will helps to know and understand the current programs and what was done before for the health of neonates and childrens in nepal. Mostly used for Public health, Nursing and Medical students. The document is developed on 2023 so, the policies and programs after 2023 was not encorporated in this document.
Review of current health service planning in Nepal from province to local levelMohammad Aslam Shaiekh
This document summarizes a review of health service planning in Nepal from the provincial to local levels. It describes the new federal system of government in Nepal with three tiers (federal, provincial, local). At the local level in Pokhara Metropolitan City, the findings show 41 health facilities serving 479,000 people. A top-down and bottom-up approach is used for health program and budget planning. At the provincial level, the Gandaki Province health directorate provides technical support to 11 districts. The challenges of implementing health planning under federalism include coordination between levels of government and building capacity of newly elected local bodies. Recommendations focus on collaboration, clarifying roles, training, and strengthening infrastructure and resources at the
National health education, information and communication centerShisam Neupane
Established under MOHP in 1993, NHEICC is responsible for planning,Implementing, monitoring and evaluating awareness raising, information, education and communication program related to health programmes and services.
The Nepal Health Sector Strategy (NHSS) 2015-2020 provides strategic guidance for the health sector over five years. Its goal is to improve health status through accountable and equitable health services. NHSS outlines nine outcomes, including rebuilding health systems and improving quality of care. It identifies key outputs needed to achieve each outcome, along with interventions, indicators, targets, data sources, and timelines to monitor progress in strengthening Nepal's health sector.
The document summarizes Nepal's Community Based Integrated Management of Newborn Care (Neonatal care) and Childhood Illness (CB-IMNCI) program. The key points are:
[1] CB-IMNCI aims to reduce neonatal and under-5 mortality by promoting essential newborn care, managing major causes of illness in newborns and children, and improving access to health services.
[2] It integrates newborn care programs with childhood illness management. Major interventions include birth preparedness, essential newborn care, treatment of neonatal sepsis, and management of childhood illnesses like pneumonia and diarrhea.
[3] The goal is to achieve targets for reducing under-5 and
This document summarizes the child health program in Nepal. It discusses the main medical causes of infant mortality and morbidity, including low birth weight, respiratory infections, diarrhea, and malnutrition. It then outlines Nepal's national immunization program, which aims to increase vaccination coverage and prevent diseases like polio, measles, and tetanus. The program is guided by national health strategies and goals to reduce child mortality and morbidity from vaccine-preventable illnesses. Key activities discussed include vaccinator training, polio campaigns, and integrated disease surveillance.
Public health intervention for newborn in nepalDeepakPandey315
This document summarizes public health interventions for newborns in Nepal. It first provides background on newborns being highest risk in the first 28 days of life. It then outlines the main causes of newborn death in Nepal. The interventions discussed include immunization programs, the "Aama Surakshya" program providing transportation incentives for institutional delivery, newborn care programs, the "Nyano Jhola" program providing newborn clothes/gowns, the Navi Malam umbilical cord chlorhexidine program, nutrition programs, and the CBIMNCI program integrating newborn and child health interventions.
Nepal Health Sector Program Implementation Plan II (NHSP-IP2)Dip Narayan Thakur
The document summarizes Nepal's Health Sector Implementation Plan II (NHSP-IP II). NHSP-IP II aimed to strengthen Nepal's health system from 2010-2015 by improving access, equity, and utilization of essential health services. It reviewed achievements and shortcomings of NHSP-IP I and outlined NHSP-IP II's vision, goals, strategies, and financing plans. Key points included reducing morbidity and mortality through accessible, affordable, quality care; addressing sustainability issues in health financing; and achieving greater efficiency through health systems strengthening. Progress was made in areas like immunization and maternal health, but challenges remained around nutrition, non-communicable diseases, and equity gaps.
Nepal began its malaria control program in 1954 with support from the United States, launching an eradication program in 1958. The program shifted to control in 1978 and was revamped in 1998 under the WHO's Roll Back Malaria initiative. Nepal has since adopted a long-term elimination strategy with the goal of being malaria-free by 2026. The program is managed through Nepal's Epidemiology and Disease Control Division and focuses on surveillance, diagnosis and treatment, vector control, and community education to achieve elimination.
National Health Policy of Nepal 2076 (ENGLISH)BPKIHS
The National Health Policy of Nepal-2076 outlines the country's vision, mission, goals, and policies for health. Its key points are:
The vision is for aware and healthy citizens. The mission is to ensure citizens' right to health through optimal resource use and cooperation. Goals include creating opportunities for all citizens to access health. There are 25 policy areas with over 100 strategies to restructure the health system according to the federal system and ensure universal health coverage through various programs and services. The policy addresses issues like non-communicable diseases, health workforce and services, and takes a more integrated approach than previous policies.
Comprehensive Field Practice (CFP) : District Health Service Management Mohammad Aslam Shaiekh
The document summarizes the activities and learnings of a group of public health students during their 30-day field placement in Surkhet District, Nepal. The group conducted various assessments of the district's health management system including a secondary data review, critical analysis using SWOT, an epidemiological study on major health issues, and a mini action project on plastic waste reduction. Key findings included gaps in safe motherhood services, increasing HIV trends, and issues with logistics management and data reporting. The placement helped the students gain important academic and management skills applicable to their public health careers.
Primary health care outreach clinic and EPI meeenamu
The document discusses Nepal's Primary Health Care Outreach (PHC/ORC) program and National Immunization Program (Expanded Program on Immunization).
The PHC/ORC program aims to improve access to basic health services for rural households through monthly outreach clinics within half an hour's walk of populations. Services include safe motherhood/newborn care, family planning, and child health. In 2075/76, the program served 2.8 million people through 138,125 clinics.
Nepal's immunization program started in 1974 and provides vaccines to children and mothers. It has helped reduce mortality from vaccine-preventable diseases. The program initially provided BCG and DPT in 3 districts and has
The document discusses disease control strategies in Nepal as outlined in the National Health Policy 2071. It identifies the major infectious diseases affecting Nepal, including tuberculosis, HIV/AIDS, malaria, and kala-azar. It also outlines strategies to control these diseases, such as expanding DOTS and ART programs, insecticide-treated bed nets for malaria, and surveillance networks. Some of the key challenges faced in disease control are cross-border disease transmission and strengthening control initiatives for diarrhea, respiratory illnesses and other infectious diseases.
The document discusses Nepal's family planning program. The main points are:
1) Family planning is a priority in Nepal to improve health outcomes and economic development. It aims to ensure individuals can fulfill reproductive needs through informed choice of contraceptive methods.
2) The government, NGOs, and private sector provide a range of temporary and permanent family planning methods through health facilities. Community health volunteers also provide information and some methods.
3) National policies emphasize increasing access, integrating services, and engaging both males and females in planning their families to improve their quality of life.
The document summarizes Nepal's Safe Motherhood program. It describes the program's goals of reducing maternal and neonatal mortality and improving health. Major activities include promoting birth preparedness and emergency funds, expanding skilled birth attendants and emergency obstetric care, managing reproductive health issues, expanding service sites, and programs like Aama that provide incentives for institutional delivery. The program aims to make quality maternal care accessible to all women through these various community-based and facility-based strategies.
The document summarizes Nepal's Safe Motherhood program, which aims to reduce maternal and neonatal mortality. It outlines the program's goals and pillars, including initiatives to address the three delays in seeking, reaching, and receiving care. Key activities include expanding 24/7 birthing facilities, emergency transport funds, ultrasound programs, and training community health workers. The program provides incentives for institutional deliveries, antenatal care, and newborn care through the Aama program.
New Microsoft Office PowerPoint Presentation(1).pdfkarishmakc1
Maternal and child health aims to improve the health and wellbeing of mothers, children, and adolescents. Its objectives include reducing mortality and morbidity during pregnancy, childbirth, and childhood. Key components are family planning, maternal and child healthcare services, and health system strengthening. Globally, the maternal mortality ratio has declined but many deaths are still preventable. In Nepal, the maternal mortality ratio has also decreased but goals remain to further reduce rates. The Safe Motherhood program focuses on increasing access to skilled birth attendants and emergency obstetric care through various community-based and facility-based initiatives.
The document discusses maternal health and efforts to improve it. It notes that while maternal mortality has declined globally in recent decades, it remains high in many developing countries. It outlines several indicators of maternal health in India that have improved between 2005-06 and 2014-15, such as antenatal care and institutional births. However, maternal mortality still varies greatly between states. The document proposes strengthening maternal health through expanding programs that provide antenatal, delivery and postnatal care, especially in rural areas, as well as improving infrastructure and monitoring systems.
This document discusses natal (delivery) care in Nepal, outlining its objectives, services, policies, and challenges. It defines natal care and outlines its key components. It describes Nepal's plans and policies to increase skilled birth attendance and institutional deliveries, including the Safe Motherhood Policy (1998) and National Free Delivery Policy (2009). The document discusses increasing c-section rates in Nepal and highlights issues like shortages of trained health professionals that pose challenges to improving natal care.
The document discusses Nepal's National Safe Motherhood Programme, which aims to reduce maternal and neonatal mortality. It does this by addressing the three key delays that can impact obstetric emergencies - delay in seeking care, reaching care, and receiving care. The programme promotes birth preparedness, encourages institutional deliveries, and expands emergency obstetric services. It has made progress through policies, training more skilled birth attendants, and revising plans like the Safe Motherhood and Neonatal Health Long Term Plan. The Aama Programme provides cash incentives for institutional deliveries and antenatal care to increase utilization of maternal health services. Evaluations found the incentives increased institutional delivery rates, though issues like false reporting need to be addressed
The document discusses international perspectives and national strategies, policies, and components of safe motherhood. It provides an overview of safe motherhood initiatives launched globally in 1987 and commitments made at international conferences to reduce maternal mortality. Key components of Nepal's National Safe Motherhood Programme include family planning, antenatal care, obstetric care, postnatal care, and programs to address issues like HIV/AIDS. The document outlines policies, strategies, current activities, and achievements of Nepal's efforts to promote maternal health.
The document outlines the goals and strategies of India's Reproductive, Maternal, Newborn, Child PLUS Adolescent Health (RMNCH+A) program. The goals include increasing coverage of key interventions like facility births, antenatal care, immunizations, and reducing issues like anemia and malnutrition. The program aims to provide continuum of care across the life stages of reproduction, pregnancy, childbirth, newborn, child, and adolescent. It focuses on community and facility-based interventions like immunization drives, nutrition programs, reproductive healthcare, and strengthening health systems. Key challenges include addressing adolescent health and improving implementation through use of data and timely payments.
The document discusses India's RMNCH+A (Reproductive, Maternal, Newborn, Child Health Plus Adolescent) approach, which aims to provide integrated health services across different life stages through a continuum of care. Key aspects of the approach include reducing mortality and malnutrition, increasing immunization coverage, and strengthening service delivery through community health workers. Progress is monitored using indicators tracked in scorecards that measure coverage of important interventions like antenatal care, institutional deliveries, postnatal checks, and child nutrition. The approach emphasizes addressing the needs of vulnerable groups like adolescent mothers through new initiatives for maternal and newborn care, child health, family planning and adolescent health.
This document summarizes several key maternal health programs in India:
1. Janani Suraksha Yojana (JSY) provides cash assistance to encourage institutional deliveries, especially for low-income women. Other programs include safe abortion services, village health days, and the Janani Shishu Suraksha Karyakram for free delivery care.
2. Newer initiatives include Pradhan Mantri Surakshit Matritva Abhiyan for free checkups, Surakshit Matritva Aashwasan for respectful maternity care, and LAQSHYA for improving quality of care during delivery.
3. The Anaemia Mukt Bharat Programme aims
The document discusses the Reproductive & Child Health (RCH) programme in India. It describes the major interventions under RCH Phase I and Phase II. Phase I focused on essential obstetric care, emergency obstetric care, immunization programs, and reducing malnutrition and anemia in children. Phase II aimed to further reduce maternal and child morbidity and mortality through promoting institutional deliveries, skilled birth attendance, and strengthening emergency obstetric care and referral systems. New initiatives included training MBBS doctors in emergency obstetric skills and establishing the Janani Suraksha Yojana cash incentive program to encourage institutional deliveries.
Public private partnership in safemotherhood program in NepalBidhya Basnet
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4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
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Brief Overview of Management of Safe Motherhood and Newborn Health Services in Nepal
1. Brief Overview of Management of Safe
motherhood and Newborn Health
Services in Nepal
Presented By :
Mohammad Aslam Shaiekh
Master of Public Health (MPH)
1Aslam Aman
2. Introduction
• The Safe Motherhood Program began in 1997 and
has made significant progress since formulation of
safe motherhood policy in 1998.
• Service coverage has grown along with the
development of policies, programmes and protocols.
2Aslam Aman
3. Introduction
• Important factors for maternal and newborn
morbidity and mortality in Nepal are:
– Delays in seeking care,
– Delay in reaching care and
– Delay in receiving care
3Aslam Aman
4. Safe Motherhood and Newborn Health
Program
Goal
• To reduce maternal and neonatal morbidity and
mortality and
• To improve maternal and neonatal health through
preventive and promotive activities and by
addressing avoidable factors that cause death during
pregnancy, childbirth and the postpartum period.
4Aslam Aman
5. SDG Target
• SDG 3: Good Health and well being
By 2030, reduce the global maternal mortality ratio to
less than 70 per 100 000 live births.
By 2030, end preventable deaths of newborns and
children under 5 years of age, with all countries aiming
to reduce neonatal mortality to at least as low as 12
per 1000 live births and under-5 mortality to at least as
low as 25 per 1000 live births.
• To achieve this target Nepal needs to reduce its MMR
by at least 7.5% annually.
• Current status: 239 maternal deaths per 100000 live
births (NDHS 2016)
5Aslam Aman
6. Major strategies
Promoting birth preparedness and complication
readiness including awareness raising and improving
preparedness for funds, transport and blood
supplies.
Expansion of 24 hours birthing facilities alongside
Aama Suraksha Programme promotes antenatal
check-ups and institutional delivery.
The expansion of 24-hour emergency obstetric care
services (basic and comprehensive) at selected public
health facilities in all districts.
6Aslam Aman
7. Contribution of Policies, Programs and
Guidelines
1. The policy on skilled birth attendants (2006)
highlights the importance of skilled birth
attendance (SBA) at all births and embodies the
government’s commitment to train and deploy
doctors, nurses and ANMs with the required skills
across the country.
2. Introduction of Aama programme to ensure free
service and encourage women for institutional
delivery has improved access to institutional
deliveries and emergency obstetric care services.
7Aslam Aman
8. • The Nepal Health Sector Strategy (NHSS) identifies
equity and quality of care gaps as areas of concern
for achieving the maternal health SDG target, and
gives guidance for improving quality of care,
equitable distribution of health services and
utilization and universal health coverage with better
financing mechanism to reduce financial hardship
and out of pocket expenditure for ill health.
• The endorsement of the revised National Blood
Transfusion Policy (2006) ensures the availability of
safe blood supplies for emergency cases.
8Aslam Aman
9. Major Activities
1. Birth Preparedness Package and community level maternal
and newborn health
2. Rural Ultrasound Programme
3. Reproductive health morbidity prevention and
management programme
a) Management of pelvic organ prolapse:
b) Cervical cancer screening and prevention training
c) Obstetric fistula management
4 Human resources
5 Expansion and quality improvement of service delivery sites
Aslam Aman 9
10. Major activities
6. Emergency referral Fund
7. Safe Abortion Service
8. Obstetric first aid orientations
9. Nyano Jhola Programme
10. Aama and Newborn Programme
Aslam Aman 10
11. Major activities in 2073/74
1. Birth Preparedness Package and community level
maternal and newborn health
• FHD continued to expand and maintain MNH
activities at community level including the Birth
Preparedness Package (jeevansuraksha flipchart and
card) and distributed the matrisurakshachakki
(misoprostol) to prevent postpartum haemorrhage
(PPH) in home deliveries.
• Three districts (Kaski, Parbat and Syangja) has
implemented this program from FY 2073/74.
• Total 48 districts
11Aslam Aman
12. Major activities in 2073/74
2. Rural Ultrasound Programme
• It aims for the timely identification of pregnant
women with risks of obstetric complication to refer
to comprehensive emergency obstetric and neonatal
care (CEONC) centres.
• Portable ultrasound is used.
• This programme is being implemented in the 12
remote districts ,Dhading, Darchula,
Sindhupalchowk, Solukhumbu, Bajura, Bajhang,
Achham, Dhankuta, Dolpa, Humla, Baitadi, and
Sindhuli.
12Aslam Aman
13. Major activities in 2073/74
3. Reproductive health morbidity prevention and
management programme
a. Management of pelvic organ prolapse:
• The government allocates funds to manage POP
including
free screening,
providing silicon ring pessaries,
Kegel’s exercise training and
free surgical services at designated hospitals.
• In 2073/74 more than 14,600 women were
screened for the reproductive morbidity, 13Aslam Aman
14. Major activities in 2073/74
• About 23 percent of women (3374 women) were
diagnosed of having POP.
• Among women who were screened 8.9 percent had
first degree POP, 6.6 percent second degree POP and
7.5 percent third degree POP.
• About 52 percent of these women with POP received
ring pessary treatment.
• More than 2,000 women received surgical
treatment.
14Aslam Aman
15. Major activities in 2073/74
b. Cervical cancer screening and prevention training
• Most common cancer of women in Nepal,
accounting for 21.4 % of all cancer among 34–64
year old women.
• The national guidelines on cervical cancer screening
and prevention (2010) call for screening at least 50 %
of women aged 30–60 yrs for reducing the mortality
due to cervical cancer by 10% with recommended
screening among this group every five yrs.
• As of 2073/74, cervical cancer screening has been
expanded to 64 districts. 15Aslam Aman
16. Major activities in 2073/74
c. Obstetric fistula management
• The government has allocated funds for the free
screening of obstetric fistula integrated with pelvic
organ prolapsed screening and free surgical services
at the BP Koirala Institute of Health Sciences (BPKIHS,
Dharan) and Model hospital, Kathmandu.
• In 2073/74, 120 women received free surgical
treatment for obstetric fistula.
16Aslam Aman
17. Major activities in 2073/74
4. Human resources
• In 2073/74, 582 SBA, 28 ASBA and 20 AA were
trained by NHTC and NAMS.
• By the end of 2073/74 a total of 9,000 SBAs and 168
ASBAs have been trained.
• FHD continued to monitor the deployment of
doctors (MDGP, OBGYN, ASBA) and AAs,and inform
DOHS and MOH as necessary for appropriate
transfer.
17Aslam Aman
18. Major activities in 2073/74
5. Expansion and quality improvement of service
delivery sites
• By the end of 2073/74 CEONC services were
established in 72 districts, only 60 districts were
functional throughout the year.
• During the fiscal year 8-12 districts provided
interrupted C-section services.
• A total of 1,811 birthing centres and 158 BEONC sites
were functioning by the end of 2073/74.
18Aslam Aman
19. Major activities in 2073/74
6. Emergency referral Fund
• A total of 4,000,000 Rupees was allocated to five
regions and fourteen women from nine districts
received support from this fund in 2073/74.
• Additional 4,400,000 Rupees was allocated to 46
districts to support transport fares women who could
not afford referral to high facility.
• The RHD/Provincial also have funds to airlift to
women from areas where motorised transport is not
available or when immediate transfers are needed.
19Aslam Aman
20. Major activities in 2073/74
7. Safe Abortion Service
• Comprehensive abortion care (manual vacuum
aspiration [MVA]) services are available in all 75
district hospitals and majority of PHCCs.
• Second trimester abortion services are available in
30 hospitals where CEONC services are also available.
• Medical abortion services have been expanded to 60
districts with the support of various partners.
20Aslam Aman
21. Major activities in 2073/74
8. Obstetric first aid orientations
• In 2070/71, FHD started orienting paramedics on first
aid to manage obstetric complications at health
facilities without birthing centres and to enable
paramedics to support SBAs and ANMs at times of
emergency.
• In 2073/74, 51 trainers were trained on this subject
in 17 districts.
21Aslam Aman
22. Major activities in 2073/74
9. Nyano Jhola Programme
• Launched in 2069/70 to protect newborns from
hypothermia and infections and to increase the use
of peripheral health facilities (birthing centres).
• Two sets of clothes (bhoto,daura, napkin and cap) for
newborns and mothers, and one set of wrapper, mat
for baby and gown for mother are provided for
women who give birth at birthing centres and district
hospitals.
22Aslam Aman
23. 10. Aama and Newborn Programme
The government has introduced demand-side
interventions to encourage women for institutional
delivery for women delivering their babies in health
institution
Transport incentives to institutional delivery
Incentives to 4 ANC
Free institutional delivery a payment to health facility
23Aslam Aman
31. Management Perspectives of Safe
Motherhood Program (POSDCORB)
1. Planning
2. Organizing
3. Staffing
4. Directing
5. Coordinating
6. Controlling
7. Recording and Reporting
8. Budgeting
31Aslam Aman
32. Planning
• Family Welfare Division (FWD) is the main body
for formulating plans and activities regarding safe
motherhood.
• Regional Health Directorate (RHD)/ Provincial
Government at provincial level and District Health
Office (DHO) at district level responsible for
planning, implementation, and supervision of SM
program.
• Operative part of planning in district level is
focused by nursing staffs (Public health nurse) of
various levels.
32Aslam Aman
33. Organizing
• Follows the pattern as per the organizational
structure of DoHS.
• Related Functions
– FHD/FWD continues support for expansion and
maintenance of various activities on safe
motherhood at community level.
– FHD/FWD continues to expand 24/7 service
delivery sites like birthing centers, BEONC and
CEONC sites at existing PHCC/HP and hospitals.
33Aslam Aman
34. Staffing
• A significant share of family health division’s budget
has been allocated for the recruitment of ANMs in
short term contract to ensure the 24 hour birthing
services at PHCC/HP levels.
• FHD as also provided fund at local level to recruit
human resource mix needed to provide surgical
management for obstetric complications at district
hospitals.
34Aslam Aman
35. Staffing
• FHD has been coordinating with National Health
Training Center (NHTC) and National Academy for
Medical Sciences (NAMS) for pre‐service and
in‐service training of health workers.
• NHTC provides training on SBA, ASBA, OT
management, Family Planning training including
Implants and IUCD, and antenatal USG.
• More than 7100 SBAs and 140 ASBAs have
already been trained since SBAtraining began.
35Aslam Aman
36. Staffing Pattern
• Central Level (FHD)
– Director (Senior executive)
• Regional Level (RHD)
– RH Directorate
– Nursing Officer (Focal Person)
• District Level (D/PHO)
– D/PH Officer
– Public Health Nurse (Focal Person)
• Below district level
– PHCC: Medical Officer and Staff Nurse
– HP: Health Assistant and Auxillary Nurse Midwive
– Health workers with SBA for 24 hours birthing center at HP level
36Aslam Aman
37. Directing
• However, the process of directing principally follows
the scalar chain and/or hierarchical pattern in SM
program as per the structure of DoHS.
• It may include but not limited to leadership,
motivation, authority delegation, issuing order and
communication from officer to focal person to
operative employees at below district level
37Aslam Aman
39. Coordinating
• Intra-sectoral coordination
Service from maternity care at hospitals and birthing
centre
MoH/DoHS, FHD, DHO/DPHO and peripheral HFs
• Inter-sectoral coordination
Deployment of staffs for birthing center at below
district level
Municipality/Rural Municipality
INGO’s and NGO’s(Save the Children, UMN,
RTI,NSI,ADRA, IPAS,etc)
39Aslam Aman
40. Recording
• HMIS form for recording the service provided by HFs at
district and below district level
• Major recording forms are under Family Health
Category No. 3
• 3.1 Face sheet Pills
• 3.2 : Depo service register
• 3.3 : IUCD/Implant service register
• 3.4 : Sterilization register
• 3.5 : Maternal and newborn health card
• 3.6 : Maternal and newborn service register
• 3.7 : Safe abortion service register
40Aslam Aman
41. Reporting
• Reporting mechanism follows the overall reporting pattern
established by DoHS/MoHP
• District Health Information System has been established
• All facilities follow the pattern through prescribed reporting
forms of HMIS
9.1: FCHV reporting collection form
9.2 : Community level health service monthly reporting form -
Immunization & PHC,ORC
9.3 : PHCC, HP reporting form
9.4 : Public hospital reporting form
9.5 : Non public health facility reporting form
41Aslam Aman
42. Budgeting
Budgeting process of SM program comes under the
overall budgeting process of health programs at
central level.
Health care financing
• The safe motherhood program has a demand side
financing approach where the mothers are provided
free delivery care at health facility with provision of
transport funds.
Program Budgeting
• Separate budgets for SM program allocated by MoH
and utilized by FHD, under various activities.
42Aslam Aman
44. Issues and
constrains
Recommendations Responsib
ilities
1.High
maternal
mortality rate
Review of programme implementation
and effectiveness
Plan for road map to reduce MMR
based on global and Nepal evidences
FWD,
DoHS,
MoH
2.Referral
mechanism
needs to be
established
Review/assessment of referral
strengthening at district level
Revise the Aama Programme to
facilitate an appropriate referral
mechanism and improve access to life-
saving services
FWD
44Aslam Aman
45. Issues Recommendations Respons
ibilities
3. No CEONC services
in some remote
districts: Rasuwa,
Manang and Mustang
Discussion with local government
on the advantages of have CEONC,
and challenges in maintaining
CEONC functionality in low
population areas
FWD
4. Federal structure
and governance of
health institutions;
limited understanding
of health service
delivery
Orientation of local and provincial
level government on their roles in
health services delivery and
governance
FWD/M
OH
45Aslam Aman
46. Issues Recommendations Respo
nsibilit
ies
5.Plateauing (State
with no change) of
4ANC use and timely
first ANC visits, and
very low PNC
coverage
Raise the quality of ANC
counseling services.
Develop a special package to
encourage timely first ANC visits.
Initiate PNC home visit in selected
councils
DHO,
DPHO,
FWD
46Aslam Aman
47. Issues Recommendations Responsibi
lities
6. Low use of
institutional
delivery and
C-section
services in
mountain
districts, and
province
number 2
and 6
Produce a strategy to reach
unreached sub-populations
Rapidly assess and expand
rural ultrasonography (USG)
Expand services in remote
and difficult locations and
ensure continuous availability
of services (birthing centres
and CEONC services
DHO,
DPHO,FWD
47Aslam Aman
48. Issues Recommendations Respon
sibilitie
s
7. Fluctuating
functionality
of CEONC
and birthing
centre
services
Monitoring service provision status
Availability of human resource
Promote the production of skilled service
providers
Ensure appropriate skill mix at CEONC sites by
deployment and appropriate transfer of skilled
human resources
MoH,
DoHS,
FWD,
NHTC
48Aslam Aman
49. Issues Recommendations Respon
sibilitie
s
7.(Contd
)
Continue allocation of fund for contracting out
short - term service providers
Provide locum doctors and anesthesia assistants in
strategically located referral hospitals for each
province
Introduce a special package to provide CEONC
services in mountain districts
Support local government for training of human
resources in necessary skills
MoH ,
DoHS,
FHD,
NHTC
49Aslam Aman
50. Issues Recommendations Responsi
bilities
8. Availability of
quality maternity
care services at
hospitals and birthing
centers
24/7 availability of
services
skills and
knowledge of staff
enabling
environment and
motivation
overcrowding at
referral hospitals.
Introduce construction
standards for birthing
centerss
Support birthing centers at
strategic locations
Provide additional
budgetary support for
overcrowded hospitals
Develop quality
improvement tools and
minimum service standards
MoH,
DoHS
50Aslam Aman
51. Bibilography
• Pathak LR, Kwast BE, Malla DS, PradhanAS, Rajlawat
R, Campbell BB. Process indicators for safe
motherhood programmes: their application and
implications as derived from hospital data in Nepal.
Tropical Medicine & International Health. 2000 Nov
1;5(12):882-90.
• Freedman LP, Graham WJ, Brazier E, Smith JM, Ensor
T, Fauveau V, Themmen E, Currie S, Agarwal K.
Practical lessons from global safe motherhood
initiatives: time for a new focus on implementation.
The Lancet. 2007 Oct 19;370(9595):1383-91.
51Aslam Aman
52. Bibilography
• Bhatta BN. Public Health Awareness Building in the
field of Safe Motherhood. Journal of Nepal Health
Research Council. 2008;6(2):69-73.
• KcA, Thapa K, Pradhan YV, Kc NP, Upreti SR, Adhikari
RK, Khadka N, Acharya B, Dhakwa JR, Aryal DR, Aryal
S. Developing community-based intervention
strategies and package to save newborns in Nepal.
Journal of Nepal Health Research Council. 2011 Dec
18.
52Aslam Aman
53. Bibilography
• www.ifrc.org,Saving lives, changing minds.”Maternal,
newborn and child health framework” International
Federation of Red Cross and Red Crescent Societies,
Geneva, 2013
• Annual Report department of Health Service
2073/74 ,Government of Nepal , Ministry of Health.
• http://www.policyproject.com/matrix/SafeMotherho
od.cfm
• http://sustainabledevelopment.un.org/
53Aslam Aman