2020 Annual Report
Letter from the CEO
It has been said many times, but it bears repeating that 2020 was a challenging year for us all. From the staggering number of lives lost to the virus to the loneliness and isolation so many have felt while in quarantine, every single person has experienced some sort of loss in the past year. Yet, as is often seen in times of adversity, OHW has grown stronger and more resilient than ever. Our team has worked diligently and made tremendous strides to continue providing essential maternal and newborn care in the rural Nepali communities that we serve. Despite the many challenges our staff faced in Nepal, thanks to their constant efforts and your donations, we were able to achieve incredible results.
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Where We Work
As of the end of 2020, OHW had 2 completed districts and 19 active districts representing 178 municipalities and a total population of 4.7M and 121,000 annual pregnancies, demonstrating the continued efficacy of our model across multiple geographies, cultures, and needs.
We added three new districts (Phase I in Sarlahi, Parbat, and Myagdi). We continued to implement our program in eleven districts (Phase II in Taplejung, Khotang, Sankhuwasabha, Okhaldhunga, Ilam, Ramechhap, Nuwakot, Solukhumbu, Dolakha, Kavre, and Udayapur). We began the transition process in four districts (Phase III in Sindhupalchok, Bhojpur, Panchthar, and Terhathum) and continued monitoring the transition process in Dhading (which transitioned to Phase III last year).
Story from the field
By Naresh Newar in Khotang & Okhaldhunga
As the chief of the Dhitung ward of Halesi rural municipality in Khotang district, Prithvi feels proud that one of his greatest achievements as the Ward Chair has been transforming the birthing center of the Dhitung Health Post into a high-quality maternal health facility. He says that this will always be his ward’s legacy. It was completed primarily due to the local government’s meaningful partnership with One Heart Worldwide (OHW).
“This achievement was a result of our local government’s partnership with One Heart Worldwide. This is the kind of partnership that will truly help local governments develop programs to benefit our underserved rural community,” says Prithvi.
He recalls how he was immediately keen when OHW first proposed their partnership for renovating the birthing center of his ward’s health post four years ago. Prior to OHW’s arrival, the health post was an old, dilapidated building. The ward office had been planning to rebuild the whole structure, but there were budget constraints and the reconstruction expenses were too high.
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MANAGING PERSONAL & PROFESSIONAL LIFE DURING THE PANDEMIC:
A story from OHW nepal’s executive director
While you have likely heard what One Heart has achieved this year in terms of program activities and results, I wanted to share with you a behind-the-scenes glimpse of what it has been like managing personal and professional challenges in Nepal, and to share how our team overcame tremendous hurdles during this time of crisis.
2020 Delivery
Program Reach in Our Active Program Districts
By the end of 2020, the OHW programs had reached a cumulative total of 283,326 pregnancies in our active program districts, in support of Nepal’s national plan to provide quality MNH services to rural pregnant women and their newborns.
Quality of Care Programs
Recent evidence has demonstrated the need to improve the quality of care as a critical component for programs seeking to improve maternal and newborn outcomes, particularly in the more remote areas, where these providers are very isolated. We have implemented several initiatives to increase our program focus on the quality of care provided in our districts:
+ A Simulation based Mentorship Program for Rural SBAs:
To improve the quality of essential obstetric and newborn care services among rural healthcare service providers in Nepal, One Heart Worldwide is starting a simulation based mentorship program for rural SBAs using the Helping Mothers Survive (HMS) and Helping Baby Breathe (HBB) packages.
+ A Rural Ultrasound Training site for SBAs:
To strengthen the local training capacity and better meet the growing training needs for trained SBAs in rural areas, OHW has been working in partnership with one of the largest maternity hospitals of Nepal, the Paropakar Maternity and Women’s Hospital in Thapathali, to establish their facility as an ultrasound training center. This new training center now doubles the country’s capacity to provide ultrasound training each year.
+ Special Newborn Care Units (SNCU):
This program aims to support the government of Nepal’s desire to strengthen the capacity of its public health infrastructure to provide quality healthcare services for newborns by establishing SNCU at the district hospital where sick newborns can be appropriately referred and treated and improving the capacity of the district hospital staff to use these new units.
+ Quality of care Assessments for Birthing Centers
We assess whether the Birthing Centers continue to function up to the required government standards which include patient management, patient referral systems, availability of water and electricity, patient dignity, equipment and supplies (including essential drugs), labor room status and infection prevention.
New Programs
Our New Maternal & Newborn Health (MNH) Emergencies Helpline
Developed in collaboration with the Government of Nepal and the Nepal Society of Obstetricians and Gynaecologists to assist rural MNH services providers in clinical decision-making during the COVID-19 pandemic, this program was designed in anticipation of scenarios where rural providers might be faced with an MNH emergency in which referral to a higher facility might be delayed or not be possible at all given the impact on travel accessibility due to the pandemic. We enrolled 781 health facilities in this program across all districts, handling 271 emergencies (pregnant women/newborns in distress at a rural health facility.)
Our New Telehealth Program for Rural Health Facilities:
This program supports medical providers in adapting their pre-COVID in-person consultations to cellphone-based consultations for pregnant women (antenatal care) and recently delivered women (postnatal care), ensuring that pregnant and postpartum women can still receive the health education and support they need during this vulnerable period while limiting unnecessary potential exposure to COVID for themselves or their providers. Launched in 583 birth centers, this program provided ANC services to 12,463 pregnant women and PNC services to 6,039 postpartum mothers. Out of these, 710 women (585 pregnant women and 125 postnatal mothers) were referred to the larger facilities for specific case management. We are very excited to be able to report that the Government of Nepal has integrated telehealth in their interim RMNCH (Reproductive, Maternal, Neonatal, and Child Health) service delivery government guidelines. As such the government is now mandating that all health facilities nationwide provide telehealth during the pandemic.
Natural Disasters Complicate the Pandemic
Program Impact
OUR GOVERNMENT PARTNERS AS AN INTEGRAL PART OF OUR SOLUTION
Our Government partners are an integral part of our program scale-up strategy in Nepal. The Central Government of Nepal invests $2 for every $1 that OHW invests in Nepal.
TRENDS IN MATERNAL & NEONATAL MORTALITY IN ACTIVE OHW DISTRICTS* OVER THE PAST 5 YEARS
*Total mortality data from Dhading, Sindhupalchok, Taplejung, Panchthar, Terhathum, Ilam, Sankhuwasabha, Khotang, Okhaldhunga, Bhojpur, Solukhumbu, Nuwakot and Ramechhap
IMPROVED SYSTEMS OF MNH cARE IN RURAL NEPAL
As a result of OHW programs, 12% of all 750,000 annual pregnancies in Nepal now have improved access to quality MNH services.
As of the end of 2020, we have reached ⅓ of our goal (ensuring quality MNH services for 250,000 annual pregnancies among the most vulnerable population of Nepal).
Looking ahead
IN 2021, OHW WILL BE ACTIVE IN 21 DISTRICTS.
We will have nine districts in full implementation phase, nine in transition phase and we will be adding three new districts.
Dhanyabad - Thank you
Dear Friends and Family,
I want to take a moment to personally thank you for all of your support. For the last twenty years, we have fought together to save the lives of mothers and children in Tibet and Nepal and have been lucky enough to see tremendous change come about as a result of our efforts. I am grateful to have had the opportunity to carry the torch and lead this incredible organization for these many years. While I can confidently say that I have served and led to the best of my ability, today, I proudly pass the torch on to David, who has already seen us through much of the COVID-19 pandemic. Though there have been challenges in the past, none compare to the overwhelming nature of the disease, deaths, and lockdown seen in 2020. However, thanks to the ingenuity and resilience of the US and Nepal teams, OHW not only has continued to successfully implement our traditional programs during the pandemic but has also introduced two new programs that specifically target and mitigate the dangers of COVID transmission. I cannot help but be reminded of a quote by his holiness the Dalai Lama XIV, “It is under the greatest adversity that there exists the greatest potential for doing good, both for oneself and others.”
I am excited to see what comes next, knowing that no matter what, OHW will continue to play a significant role in saving the lives of mothers and children across the globe for years to come.
Thank you for being a part of this beautiful journey with me.
With gratitude,
Arlene Samen, Founder of OHW & Chief Visionary Officer
