Safe Motherhood in Nepal

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Appreciative inquiry improves local services

SSMP/Options and partners have successfully used the technique of Appreciative Inquiry (AI) for strengthening health facility management in programme districts, helping to improve maternal health services and increase their utilisation. More recently this has been scaled up under government funding in 50 health facilities in 28 districts through a contract with a private company, Genesis Management. The main aim was to encourage local facilities to start 24-hour delivery services and to improve the quality of emergency obstetric care in hospitals. Genesis Management conducted AI participatory planning workshops in district hospitals and trained teams of district facilitators to roll this out to the local level health facilities, with back-up support. 

An evaluation of the process showed that the AI process had helped increase demand for services from communities, as well as strengthening services. In particular:

•    more women were going for antenatal and postnatal checkups, and delivering their babies in a health facility.
•    The cleanliness of maternal health clinic rooms, waiting areas and surrounding environment had improved, and the availability of clean toilet facilities and drinking water for patients and care takers. In many cases VDCs had provided small amounts of financial support for improvement of physical facilities, but the main reason behind improvements was the increased levels of activity of management committees and commitment of health staff.

The evaluation recommended further scaling up the process through district level AI coaching by external consultants and the DHO, to enable district teams to conduct workshops at peripheral facilities

Click here to view the full evaluation report and the four-page summary.