2021 Annual Report
Letter from the CEO
Our team has come a long way since our founder, Arlene Samen, initiated the maternal and newborn health project which would eventually become the Network of Safety. The movement to ensure that every mother has access to a safe and healthy birth experience is growing stronger every year. Not even a second year of a global pandemic was able to slow us down. Thanks to your continued support, we exceeded almost all of our program targets, strengthening the capability of the local health system in 21 rural districts of Nepal and reaching an impressive 86,000 pregnancies in 2021 alone. In addition to our regular programs, we orchestrated a comprehensive COVID response and distributed $22M worth of essential emergency medical equipment and supplies to ensure continuity in access to quality maternal and newborn health throughout Nepal.
To support our programs throughout the pandemic, we developed new initiatives including a social media support group for Skilled Birth Attendants and a set of COVID-related infographics and videos. We also digitized a number of our clinical training programs allowing for a wider reach during lockdowns. Last but not least, we continued the implementation of our telehealth program, our MNH helpline, and our radio messaging program. All of these programs are currently being assessed for long-term inclusion into our Network of Safety model.
2021 has also been a marker of many exciting changes for our team. We have brought on a new Director of Development and Partnerships to help expand our partnerships in Nepal and globally, and we have submitted our five year Project Agreement renewal to Nepal’s Social Welfare Council (approved as of February 2022). Now more than ever, I am thankful for our community of long-term partners and supporters. Over the next three years, our goal is to achieve our stated program expansion goal of 36 districts in Nepal by adding 12 new districts (4 per year). To this effect, we are building a platform for growth through increased organizational visibility and extended learning, strengthened programmatic and operational capacity, establishing stronger local partnerships, and identifying and operationalizing new digital platforms. I look forward to keeping the momentum going with all of you into 2022!
Sincerely,
David Murphy, CEO
Where We Work
In 2021, OHW had 3 completed districts and was active in 21 districts representing 198 municipalities, a total population of 5.3M and 132,000 annual pregnancies.
Despite the COVID pandemic delaying the implementation for our programs in Sarlahi, Parbat, and Myagdi and the set-up process of our three new districts (Rautahat, Rukum West, and Salyan), we reached 86,000 pregnancies in our active program districts. This success was largely due to the adaptation of our programs to the new post-COVID landscape (including new programs, new safety protocols, and the digitization of several existing programs).
Story from the Field
Creating quality maternity care is not just about constructing a new birthing center and providing quality equipment. It is also about promoting ownership among local stakeholders to create a sustainable MNH system that can help nurses to save lives.
Sipali Chilaune Health Post (HP) is located in the District of Kavrepalanchok, only 35 miles from Kathmandu but a journey not for the faint-hearted. The roads leading to the health post are dangerous even for off-road vehicles, and the monsoon rains render them all but impassable for half the year.
Program Achievements
OHW’s delivery indicators measure the activities implemented by OHW to achieve our larger objectives. They include capacity building, infrastructure, and community outreach initiatives.
Cumulative Program Delivery in Nepal
2021 Delivery
Number of Pregnancies Reached
By the end of 2021, OHW programs reached a cumulative total of 369,155 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.
OHW’s Support in Nepal’s Fight Against COVID-19 Pandemic
Working at Belka Hospital of Udayapur district, Nurse Sabina has a very tight work schedule. With more than 224 birth deliveries in a year, the workload is heavy for Sabina and her small team. “So many mothers count on us for their lives and for safe deliveries, and even during the height of the pandemic, we couldn’t stop our services,” says Sabina.
OHW COVID Response in 2021
Partner Highlight - Direct Relief
Since their first in-kind support in 2011 towards the upgrade of a birthing center in rural Dolpa, Direct Relief has been a consistent and compassionate partner who shares our commitment to the health and well-being of pregnant mothers and their newborns in hard-to-reach areas. One of the first to deliver critical emergency and long-term support in the aftermath of both the devastating earthquakes in 2015 and the global COVID-19 pandemic, Direct Relief also provided OHW’s largest ever gift with over $21M of equipment and supplies in 2021 which helped turn the tide as the virus threatened to overwhelm the already fragile healthcare system in rural Nepal. We are forever grateful for Direct Relief’s partnership.
Increased Visibility of One Heart in Nepal
One Heart was featured extensively in Nepal’s local media this year, as well as in several global peer-reviewed journals including the Lancet and the BMJ, in recognition of our leadership and contribution towards the national COVID response. This has led to more awareness of our organization and mission throughout all of Nepal among both local and international entities.
Research & Development Highlights
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is a training program to improve the quality of healthcare services provided by skilled birth attendants (SBAs) in rural areas. The program uses a low dose high frequency training approach (shorter sessions offered more frequently) to refresh and maintain essential clinical skills for rural SBAs. OHW successfully launched this intervention in both Dolakha and Udayapur, training 27 master trainers and Palika mentors and setting up 7 skill labs. With all initial data collection completed and consistent monthly mentoring sessions, early feedback from participants continues to be positive. We look forward to expanding this program in Sarlahi and Myagdi in 2022.
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is designed to assist rural MNH service providers in clinical decision-making when faced with an MNH emergency in which referral to a higher facility might be delayed or not possible at all. OHW had 530 Birthing Centers enrolled in this program across all OHW districts in 2021. Program results show a decrease in referrals from rural birthing centers as a result of increased local case management; improved confidence among rural MNH providers; and improved communication between rural providers and referral hospitals. These findings have been shared with government partners and relevant stakeholders in the hope that the intervention might be adapted and scaled nationwide.
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supports rural healthcare providers in adapting in-person consultations to cellphone-based consultations for antenatal care and postnatal care, ensuring continuity of service delivery while limiting unnecessary potential exposure to COVID. The Government of Nepal formally adopted the telehealth program into their official service delivery guidelines during the pandemic. OHW had 762 health facilities enrolled into this program as of the end of 2021. Program results show positive feedback from pregnant and recently delivered women with regard to improved access to ANC/PNC information and relationships with their providers, but also revealed concerning gaps in providers’ awareness of national guidelines for delivering MNH services during COVID, as well as in appropriate distribution of Misoprostol. These findings were shared with government partners and stakeholders to improve service delivery at the rural health facility level.
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in an effort to strengthen the training capacity of the Provincial Health Training Center from Province One, we supported an additional RUSG training center based out of the Koshi Zonal Hospital in Biratnagar. Additionally, based on the findings and recommendations from a 2020 evaluation of the GoN’s rural ultrasound training program, our team partnered with the National Health Training Center (NHTC) to revise the existing training package into a competency-based standard curriculum that improves service delivery quality.
Financials
Looking Ahead
Over the next three years, we will continue to scale and adapt our interventions to ensure access and quality of MNH care within a highly fluid environment that includes a national health care system that has continued to be overwhelmed by the pandemic over the past two years. Our efforts to digitize critical elements of our training programs and expand the way we collect, analyze, and leverage our data have the potential to revolutionize both OHW and our local government partners’ ability to effectively investigate localized MNH issues, respond appropriately, and better anticipate emerging needs.
2022 PROGRAM REACH:
Now in our twelfth consecutive year in Nepal, our programs are expected to reach 87,000 pregnancies in 2022 alone, and more than 300,000 pregnancies over the next 3 years. In 2022, our programs will be active in 20 districts, having completed transition in 9 districts already. We will have 12 districts in full implementation phase including a partial program in our previous district of Dolpa to implement targeted programs focused on improving quality of care; 4 districts in transition phase and most importantly, we are accelerating our program roll-out, adding 4 districts per year over the next three years to achieve our mandate of 36 districts in rural Nepal.
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Starting in 2022, our government partners have mandated that we incorporate local NGOs into the implementation process of our model for our new program districts. This new mandate will be very helpful in the Terai and the Karnali where our initial assessment recommended additional community-based activities, preferably conducted by local teams more familiar with the cultural landscape in these districts. To align with this requirement, we developed engagement guidelines and subsequently identified one local NGO partner in each of our new program districts to support our community-based work. THE
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The full extent of COVID’s impact in Nepal is still not completely clear as each wave and new variant brings new challenges, but there is no doubt that the pandemic has tremendously affected the Nepali healthcare system. In response, OHW will continue to adapt our model to better respond to the changing needs on the ground, including additional emergency response programs to ensure continuity in MNH service delivery. Since 2015, we have orchestrated emergency response efforts in Nepal via strong relationships with our governmental partners. The partnerships and skills built throughout the years may prove valuable as COVID continues to evolve and climate change becomes an ever-increasing concern as Nepal deals with intensifying monsoon conditions and landslides.
Welcoming Our New Director of Development & Partnerships
Joining One Heart Worldwide has been an amazing journey since July 2021. The Network of Safety model is what first attracted me to One Heart Worldwide. Through this well-crafted model of localized partnership, we continue to amass evidence of how we are impacting MNH in the districts where we have completed our work in Nepal. In the future, we will be extending our focus to gain insight into not only how, but why the model is working.
One of the most important lessons we have learned over the past decade is that health systems strengthening for MNH can only be achieved if it is an integral component of a national strategy. Parallel systems may provide short-term relief, but there is a cost to working outside of the system. As we continue to grow, One Heart Worldwide will remain committed to working closely with a wide array of government and local partners from the initial stages of implementation. This approach ensures that we are continually addressing the most pressing MNH needs alongside our many partners while also closing critical gaps within the health care system.
One of the most interesting aspects of my work is creating meaningful opportunities for engagement with our international partners and social investors. As we build on what is working in the coming year, we will continue to seek out new partnerships to achieve our vision for strategic growth. We will share our lessons with our local partners and international peers to promote cross-organizational learning and to raise our profile on the global stage. By adopting innovative approaches to mobilize essential human and financial resources for success, we aim to remain responsive and nimble in an ever-changing global environment. Working collectively toward our shared goals, together we can positively impact the lives of pregnant women and their newborns in Nepal and beyond.
Dr. Julie Dargis,
Director of Development and Partnerships
Staff Highlight
Poonam shakya
Administration and Finance Director
My name is Poonam Shakya and I have been working with One Heart for three years in OHW’s Kathmandu office as the Administrative and Finance Director. My role is to ensure proper financial & resource management, in addition to policy compliance. As one of the essential foundations of the organization, the administrative and finance unit makes the organization stronger from within by supporting program delivery and helping the organization to responsibly achieve its goals. In the coming years, I will also lead our team effort towards the overall growth of the organization.
What I like most about OHW is the adaptability of our work, program, and activities in addressing the needs in Nepal’s changing and challenging context. Our adaptability was especially evident this year when Nepal faced the second wave of COVID-19, overwhelming hospitals with an influx of severe COVID patients. We were entrusted with a significant amount of COVID-specific funding in response to the crisis, and our team was tasked with managing the procurement and distribution of PPE. Within such a limited time frame when most organizations (including government organizations) were working from home, this was no simple task, but our team came together to tackle the challenge head on. From the most senior-level staff to the support staff, everyone was involved in the packing and labeling of the supplies and distribution to city hospitals and remote health facilities alike.
On top of the challenge with COVID, we unexpectedly lost our Finance Manager and friend, Rajesh Shrestha. He was the central pillar of the admin and finance unit and his loss left a huge gap during the peak season in our department. I am very proud of our team and their dedication in sharing, without any reluctance or hesitation, the responsibilities of the audit, the annual budgeting process, and the project development for the next 5 years.
If there is anything that I have come away with this year, it is understanding the value of teamwork and mutual support. I am excited to see what next year has to bring and feel confident that we will be able to handle anything.
