Follow up Survey on CB-MNC Program in Jhapa, Banke and Kanchanpur Districts

Abstract

Executive Summary: Introduction: Nepal’s second long-term health plan (1997-2017) has stressed the need for interventions to improve the women and children’s health. To achieve these goals a number of national and sub-national programs have been implemented. Community-Based Maternal Neonatal Care (CB-MNC) was one of such projects implemented in the country. CB-MNC was introduced in three districts (in the third quarter of 2005 in Jhapa and Banke; and in the late 2006 in Kanchanpur), to demonstrate an integrated implementation framework including several elements (some of them are new, some of them strengthened versions of existing programs). As well as implementing or strengthening existing programs such as 'iron intensification' and the 'birth preparedness package' (BPP), CB-MNC was intended to demonstrate the feasibility of a community-based approach to prevention of postpartum hemorrhage (the most important cause of maternal deaths in Nepal), introducing oral misoprostol distributed by Female Community Health Volunteers (FCHVs). Other novel elements included, in Kanchanpur, screening for low-birth-weight (LBW) and providing more intensive follow-up care to the cases identified (this aspect of the work was implemented under the USAID-funded ACCESS project). The program area includes rural portions of the three districts. The target populations are pregnant women and newborns. Baseline surveys were carried out in 2005 in Jhapa and Banke, and in 2006 in Kanchanpur. Through follow-up surveys it has been possible to assess changes in knowledge, attitudes and practices regarding maternal and newborn care that could be attributed to the program interventions.