ZERO HOME DELIVERY AND SUSTAINABILITY OF BIRTHING CENTER

There is no equitable access to receive quality health care services in rural and urban areas Nepal. District Health Office is responsible for providing preventive, promotive and curative health services through and array of Primary Health Care Centers (PHCC), Health Post (HP), Sub-Health Post (SHP) and outreach programs. But there are no sufficient and appropriate technologies available in the health facilities. The government of Nepal has policy of establishing Birthing Center (BC) in each health facilities but it is not available though. Policy does not work itself but it should be implemented honestly. The national health indicators are very poor to achievement the Millennium Development Goals (MDG).

Regarding Baglung district, the Safe Motherhood indicators of last few years seem to be very poor. The institutional delivery with SBA is only 39 percent in fiscal year 2070/71 - Source DHO, Baglung, 2070/2071. During this situation many health facilities take initiation to improve the indicators. Among many health facilities we can take Tangram Sub-Health Post as a model one.

Tangram VDC has population of nearly forty-three hundred and its health post lacked BC till 18th June, 2014. This VDC is just 9 kilo meter far from the Dhaulagiri Zonal Hospital and District Headquarter. Before establishment of BC, almost all mothers delivered at home, there was rare antenatal and postnatal checkup. After long exercises and advocacy community people, political leaders, FCHVs, Media, schools and many other stakeholders committed and established the Birthing Center in Tangram Sub-Health on 18th June, 2014. They had community support during entire period of construction, fund raising, health education, awareness raising, media coverage etc. They have now fully equipped birthing center. There is solar system which is used as alternative power source during load shedding. The local Village Development Committee (VDC) has also contributed to building maintenance and human resource (has recruited one SBA trained nurse). This might also be one of the contributing factors for the reducing high maternal and neonatal mortality in our country. This birthing center has financial and technical support of the One Heart World Wide (OHWW) and Social Welfare Association of Nepal (SWAN) respectively under the project named Maternal and Child Health in closed coordination with DHO, Baglung.

“We were tired of facing many tragedies with mothers and newborns’ health, and this time we have taken initiation to establish the Birthing Centers.”

-Ms. Radha KC, Staff Nurse, Tangram Sub Health Post

Before the opening of BC, the SBA and other health workers used to visit the pregnant women home to conduct delivery. Besides OHWW and SWAN, the community also actively contributed in the opening of the BC. There was monetary as well as labor contribution from the community people. Thus, there was enthusiastic presence of locals during the inauguration process. The opening ceremony was embraced with the tunes of Panche Baja. The birthing center was inaugurating with more than 500 community participation in the present of the Senior Public Health Administrator (SPHA) from the DHO, Baglung.

“If every community takes initiation like Tangram, then we can save each mother’s and newborn’s life.”-Maheshwar Shrestha, Senior Public Health Administrator, District Health Office, Baglung.

He told like this initiation would be taken through every health facilities then we can able to achieve the Millennium Development Goal.  According to the SPHA this Tangram Sub-health post would be the sample of birthing center in the Baglung District.