Q3 Report 2024

We are pleased to share the final external evaluation report of the work conducted by Dartmouth College and Social Sciences Baha. The experience of conducting this evaluation has taught us an enormous amount, both in terms of our program and regarding the challenges of having an external team assess our work amid a global pandemic. We are happy that the report demonstrated some of the positive impacts of our intervention. We have also been able to capitalize on some of the issues identified by the study as areas where we should increase our programmatic focus. Last but not least, after facing what seems like every conceivable challenge possible during our initial study, we are now much better equipped to conduct future surveys. We are currently in the process of looking for new partners to conduct additional impact assessments in order to complement this report, which we consider as initial results. 

The “Saving Lives at Birth” (SLAB) research project will evaluate the effectiveness of the USAID-sponsored simulation training labs on improving maternal and neonatal health outcomes. Baseline data collection began at two project sites - Paropakar Maternity and Women’s Hospital and Surkhet Provincial Hospital. Data collected includes the proportion of women experiencing postpartum hemorrhage (PPH), the proportion of women receiving blood transfusions after experiencing PPH, and the proportion of newborns with APGAR scores of less than 7 five minutes after delivery. Two data collectors were hired at these sites. The maternal and newborn health staff of these two hospitals were also oriented on the SLAB research objectives and data collection. Lastly, the research and program inception meetings were conducted at the Pokhara Academy of Health Sciences this quarter. 

The findings of the baseline study in Kalikot were shared among all stakeholders, including the District Health Service Office Chief and their staff; health coordinators from all nine municipalities; district health staff; and representatives from other NGOs working in the district. All of the stakeholders acknowledged the importance of this community-level study, as it provides more precise information that is not captured by the usual health reporting system. The full report of the study was shared with district and municipal health officials for use in planning and implementing the appropriate interventions.

A national-level dissemination of the SBMP was conducted on August 2, 2024, in Kathmandu in the presence of local-, provincial-, and national-level stakeholders. Participants included representatives from the government (Ministry of Health and Population, Family Welfare Division, Lumbini and Madhesh Provincial Health Training Centers), as well as health service directorates, hospitals, health posts, municipalities, the Surkhet Human Resources Development Center, the Midwifery Society of Nepal, the Nepal Public Health Association, the Nepal Society of Obstetricians and Gynecologists, and different external development partners. Overall, 66 participants attended the dissemination event. Participants remarked that the SBMP is very important for improving the capacity of Nepal’s nursing staff, especially in rural health facilities. The government-level stakeholders suggested scaling up the program in other districts as well. 

We plan to evaluate the implementation and impact of long-term local-level health plans in improving local health sector performance. The study will be conducted in eight municipalities (four intervention sites and four control sites). A ten-member research committee (including representatives from the Ministry of Health and Population) and a six-member working team have been formed, and initial meetings began in August 2024.

We are looking at opportunities to partner with Jacaranda Health to adapt and pilot PROMPTS, their AI-powered personalized health navigator, in the two pilot districts of Jajarkot and Dailekh. This digital platform specifically targets pregnant women and new mothers. It combines personalized SMS nudge messages with an AI-powered clinical helpdesk that detects intent and triages incoming questions from pregnant and recently delivered mothers. The SMS messages include antenatal care reminders, infant immunizations, and other key behaviors linked with better MNH outcomes. The helpdesk is a space for pregnant women and new mothers to ask questions, and it sparks a rapid referral chain involving trained nurses if a problem is identified during the exchange. The Jacaranda team has demonstrated that PROMPTS effectively improves access to MNH care in the sub-Saharan context, and we are excited to see if it will be as successful in Nepal.