Dartmouth College - External Impact Assessment

Research & Development Update

The Dartmouth-led team resumed their activities after a nine-month delay due to the pandemic.

The protocol was modified to consider the new COVID-19 safety protocols and modifications to our data collection instruments in an effort to differentiate the effect of our program from the impact of COVID-19 on access to and utilization of MNH services.

Approval for these modifications was obtained from the Nepal Health Research Council. New field teams were hired and trained.

We expect phase - 1 of the fieldwork (data collection process) to be completed by the end of Q1 2021.

DHIS-2

Research & Development Update

DHIS-2 is the electronic version of the current aggregated service delivery data reporting system collected in each health facility.

OHW is assisting the government in transitioning the current paper-based process to the electronic version in three of our current districts (Sindhupalchok, Sankhuwasabha, and Terhathum).

This quarter, our team completed training sessions with 103 healthcare workers despite the pandemic.

Data collected from the facilities enrolled in the program show significant improvement in both timeliness and quality of reporting.

As of the end of 2020, this program’s rollout has now been completed in all palikas nationwide.

HMIS 3.6.1

Research & Development Update

HMIS 3.6.1 is a pilot study of an individual patient record system that does not aggregate service delivery data.

We had planned to have completed this pilot project by the end of 2020.

As with many other research projects, our project was interrupted by the COVID pandemic.

This quarter we continued to provide on-site coaching and support for the 20 SBAs that were trained prior to the lockdown.

The remaining 65 SBAs requiring training will receive it by the end of Q2 2021.

Maternal and Newborn Health (MNH) Emergencies Helpline

Research & Development Update

OHW developed a helpline to assist rural MNH services providers in clinical decision-making.

This program was designed in anticipation of scenarios where rural health services 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 and remoteness.

We enrolled another 2 facilities in this program during Q4 bringing the total number enrolled to 781.

During Q4, 87 emergencies (pregnant women/newborns in distress at a rural health facility were managed through the helpline.

Telehealth Program for Rural Health Facilities

Research & Development Update

This program allows Skilled Birth Attendants to provide cellphone-based consultations for pregnant women (antenatal care) and recently delivered women (postnatal care).

This ensures that all women can still receive the health education and support they need during this vulnerable period while limiting unnecessary exposure to COVID-19.

Including the 127 health facilities enrolled in Q4 alone, we have rolled out this program in 583 health facilities in total, impacting 4,424 pregnant women with ANC services and 3,030 postpartum mothers with PNC services.

Continuum of Care Simulation-Based Mentorship Program for SBAs

Research & Development Update

We received 50 sets of birth simulators and skills trainers donated by Laerdal Global Health to implement this mentorship program.

OHW is working with Laerdal Global Health to design and implement this simulation-based training program.

The training manual draft is currently under review and is expected to be finalized by the end of Q1.

We expect to start the first batch of training in Dolakha and Udayapur as soon as the manual is completed.

Rural Ultrasound Training Curriculum Revision

Research & Development Update

Based on the recommendations from our evaluation of the rural ultrasound training program, we began to revise the current training package to make it a competency-based standard curriculum in order to improve the quality of service delivery.

We are working in partnership with the National Health Training Center (NHTC) who recently formed an expert technical working group for this curriculum revision process.

We expect the curriculum revision to be completed by the end of Q2 2021.