The Support to the Safe Motherhood programme (SSMP) partnership agreements with UNICEF, United Mission to Nepal (UMN), Ipas and ActionAid ended during this reporting period, and as SSMP moves towards closure, the focus has been on evaluation of achievements at all levels, and ensuring their sustainability. To this end, the SSMP/ Options team and partner organisations have been actively involved in planning for the next Nepal Health Sector Programme (NHSP II, 2010-15).

This is the bi-annual report from January to June 2009.

In the final stages of Support to the Safe Motherhood Programme (SSMP), it is important to look at future sustainability of programme interventions and support, in particular considering system strengthening and the system’s ability to change when needed as the basis of sustainability. In this report we use a framework drawn from the WHO Countdown Working Group on Health Policy and Health Systems paper, Assessment of the health system and policy environment as a critical complement to tracking intervention coverage for maternal, new born, and child health, published in The Lancet, 12 April 2008, to look at sub-sector issues around the delivery of safe motherhood services and to assess sustainability.

This report reviews progress against the eight outputs of the Support to the Safe Motherhood (SSMP) logical framework for the past six-month period; 1st January to 30th June 2008. The reporting period began with the DfID annual programme review and finalisation of the SSMP revised Technical Assistance (TA) plan for the remainder of the programme period, which ends in November 2009. These two events have guided SSMP’s work during the period and responded to the Government of Nepal’s request that SSMP continue with the same level of technical support in order to maintain the encouraging momentum generated.

This summary includes key points for the whole of 2007, from the biannual reports for the periods January to June 2007 and July to December 2007. The year began with the mid term Output to Purpose Review of Support to the Safe Motherhood Programme (SSMP), which was positive about the achievements of a complex programme operating in a sometimes challenging political context of change and uncertainty in Nepal. Some programmatic changes were recommended, the most significant of which was a one-year no cost extension, which was granted by the Department for International Development (DfID) in July 2007, to take the programme through to November 2009. Based on this and in line with a request from Family Health Division (FHD), in December of this year the SSMP technical assistance was re-planned to utilise the additional time available and take into account programme learning and current government priorities. This will be submitted to the SSMP Advisory Group and Director General of the Department of Health Services for their endorsement, prior to forwarding to DfID..