Developed in collaboration with the Family Welfare Division of the Government of Nepal, the SBMP is a hands-on, workstation-based coaching and mentoring program that provides short doses of regular demonstrations and drills to rural health providers. This quarter, we developed 13 mentors by providing a seven day training in Sarlahi District (6 from Rautahat, 2 from Dolakha, 2 from Myagdi, 1 from Udayapur and 2 OHW staff) this quarter. We also completed pre-assessments at 2 sites (1 in Sarlahi, 1 in Myagdi), first post-assessment at 8 sites in Dolakha, and a second post-assessment at 1 site in Udayapur. We successfully ran 39 monthly SBMP sessions this quarter (1 in Dolakha, 25 in Sarlahi and 13 in Myagdi). Similarly, we provided a 3-day MNH update training to 16 participants in Sarlahi.

The external evaluation teams from Dartmouth College and Social Science Baha have been cleaning and processing the data collected last quarter in the selected study areas in Sankhuwasabha, Dhading, Baglung and Pyuthan. They have produced tables and outlined the framework for their final report. We expect the report will be finalized by the end of Q1 2023. This evaluation aims to assess how our programs have impacted the lives of women and newborns. Additionally, the evaluation seeks to address questions concerning medium and long-term sustainability, replicability, and areas where the Network of Safety could be adapted or re-imagined to best meet the needs in Nepal and other countries in need.

Creative Solutions for Health Pvt. Ltd was selected to do the endline survey in Khotang and baseline survey in Rautahat districts. After getting ethical approval from the Nepal Health Research Council, they trained research assistants and supervisors on data collection methodologies. They are now collecting data in both districts. The data collection will be completed by mid February 2023 and the first draft report will be available by the end of Q1 2023.

Earlier this year, One Heart contracted a third-party research agency in Nepal (MITRA SAMAJ) to conduct an endline survey in Dhading. This survey was conducted among women who gave birth within the last 12 months to assess the changes in our program indicators post program completion. This past quarter, the research team shared their results which showed increases in both SBA attended deliveries and institutional deliveries and reductions in maternal and newborn mortality.

One Heart piloted an intervention for a facility-based electronic health record system (HMIS 3.6.1) to allow providers to easily track facility and patient level data in 40 health rural facilities in Sankhuwasabha district. Pregnant women were registered electronically in the HMIS system and received automated SMS message reminders and phone calls from nursing staff for follow-up visits. We assessed the intervention’s acceptability, appropriateness and feasibility. The study found that the intervention was well accepted by both nursing staff and recently delivered women and that there were improvements in continued service utilization after the intervention. Some of the women shared that they found the reminder SMS messages useful in continuing their check-ups, and that they had visited health facilities or referred themselves to hospitals based on the danger signs that they learned from the SMSes. However, the study faced many challenges including recurring technical issues with the software package, internet connectivity, availability of power, limited computer literacy and dependence on the existing paper based system. For example, while most nurses reported that they made follow-up calls to women, many of them did so using the old paper-based register.