UNICEF has an established programme women’s health in Nepal, and under the SSMP contract worked to strengthen SMNH services and increase access in eight districts (Panchthar, Kavre, Saptari, Sunsari, Dang, Jumla, Achham, Humla), building on the work of their previous Women’s Right to Life and Health Project (WRLF). Specific hospitals, primary health care centres and health posts were targeted with the aim of ensuring their capacity to provide 24 hour quality midwifery services with emergency care and/ or referral services, as appropriate, for cases with complications. UNICEF also worked to build the capacity of the district health offices and facility management bodies.

Community involvement was a key factor, especially through local “Watch” groups, health facility management committees and Female Community Health Volunteers (FCHV), who were trained to educate and support families in SMNH care and to act as a referral point. UNICEF also supported the establishment of emergency funds to provide financial assistance to women in need of emergency obstetric care, managed either by the district hospitals or by communities.

By working closely with the Family Health Division and SSMP services working group UNICEF contributes to the development of key government policies, such as the skilled birth attendance, and tools such as the needs assessment tools and MNH package, feeding district experience into central level work.

This work was a core component of UNICEF’s Decentralised Action for Children and Women (DACAW) programme, which will continue to support the Nepal government’s decentralisation agenda through coordination with line agencies in districts and integration of programmes for the realisation of the rights of children and women under district development committees. UNICEF has a mandate to support a rights based approach, which includes building the capacity of duty bearers, such as health staff and local governance officials to be accountable to rights holders such as pregnant women and their families.