Safe Motherhood in Nepal

This six-month reporting period began with the independent Output-to-Purpose Review (OPR) of the programme, following which the SSMP logical framework was revised to fit more closely with the national safe motherhood programme framework and to address recommendations in the OPR. The review was generally positive about the achievements of SSMP, in a sometimes challenging political context of change and uncertainty in Nepal. One of the key recommendations was for a no-cost extension, which has now been agreed by DFID for a period of one year. There have been a number of staff changes in the SSMP core team, including appointment of a deputy team leader, and a new team leader. A significant milestone during this period was the publication of the final report of the Nepal Demographic and Health Survey (NDHS) 2006, which indicated a dramatic decline in the maternal mortality ratio, from 539 to 281 per 100,000 live births. SSMP has been closely involved in supporting the survey and plans for further analysis of the data.

Overall the programme has progressed well over the last half year, both at national and district level, as colleagues within the Government of Nepal have developed a deeper appreciation of the different components of Support to the Safe Motherhood Programme (SSMP) and how the district level partner work complements the central advisory role of the core team, which in turn supports the government. This is very encouraging, despite disruptions due to civil disturbances and changes in key officials within the government. The SSMP team is continuing to consolidate work around the logical framework as a tool to strategic programme development and planning.

A significant milestone during this reporting period was the finalisation of the Support to the Safe Motherhood Programme (SSMP) logical framework. As this was based on the revised National Safe Motherhood and Neonatal Health (SMNH) long term plan, it was necessary to await the completion of the revision process for this before proceeding with the SSMP framework. Four outputs were selected from the eight national long term plan outputs, supporting the government in the key areas of (1) policy and strategy (2) social empowerment (3) services (4) information and research.

This report covers the period July to December 2005, which represents the first half of year two of the Support to Safe Motherhood Programme (SSMP). In this period, much has been achieved in terms of: · establishing a presence at district level which will both provide support to maternal health services on the ground and will also build an evidence base for a more strategic approach to policy development and cross-departmental planning and working; · continued development and roll out of the government’s maternal health strategy; · reducing the cost barrier to essential obstetric services; · technical assistance to departmental planning and budgeting for delivery of the government’s maternal health plan utilising SSMP financial aid; · building evidence based practice within the Ministry of Health and Population; · working to improve SSMP’s identity within the Ministry and relevant departments; · and working in partnership with Government.

This report covers the period July to December 2005, which represents the first half of year two of the Support to Safe Motherhood Programme (SSMP). In this period, much has been achieved in terms of: · establishing a presence at district level which will both provide support to maternal health services on the ground and will also build an evidence base for a more strategic approach to policy development and cross-departmental planning and working; · continued development and roll out of the government’s maternal health strategy; · reducing the cost barrier to essential obstetric services; · technical assistance to departmental planning and budgeting for delivery of the government’s maternal health plan utilising SSMP financial aid; · building evidence based practice within the Ministry of Health and Population; · working to improve SSMP’s identity within the Ministry and relevant departments; · and working in partnership with Government.