When a Community Decides Enough is Enough
📍Salyan District, Karnali Province, Nepal
The old birthing room at Shibarath Health Post was too small to work in safely.
The health workers knew it. The mothers who delivered there knew it. The Health Facility Operations and Management Committee (HFOMC) knew it. And the community members who had been asking for something better for years certainly knew it.
Shibarath Health Post sits in Bagchaur Municipality in Salyan District. The ward is connected through the Rapti Highway, but internal road access is unreliable, making it difficult for families to reach care during emergencies and in bad weather. Most households depend on subsistence farming, daily wage labor, and seasonal migration. Limited income makes the cost of transportation and health-related expenses a real barrier, particularly for pregnant patients. Despite all of this, demand for institutional delivery at Shibarath has always been high. The infrastructure simply could not keep up.
The old building was cramped and inadequate, and privacy for laboring mothers was compromised. Infection prevention practices were difficult to maintain given the physical layout. Health workers were dedicated, but they were working in conditions that made it hard to deliver the quality of care their patients deserved.
When One Heart Worldwide (OHW) and Dalit Development Society (DDS) began working with the municipality, the problems were carefully documented. OHW’s engineer conducted a detailed assessment. The findings were shared at health planning and budgeting workshops and at municipal-level meetings, ensuring that local stakeholders understood exactly what needed to change and why.
Bagchaur Municipality agreed to cover 50% of the construction costs, with OHW covering the remaining 50%. Essential medical equipment was also provided. Ground was broken in 2023, and the new building was completed in late 2024.
Since then, 104 women have given birth in the new facility.
In December 2025, a joint monitoring visit brought local government representatives, health officials, and community stakeholders to Shibarath Health Post to see the results firsthand. What they observed was a transformed facility and a community that had taken genuine ownership of it.
“This new birthing center has really helped us provide essential health services, and overall, we are very happy with it,” said Tek Bahadur Rawat, Public Health Officer at Shibarath HP. “We have conducted more than 50 deliveries here, and the equipment provided by the project has been very useful for our daily work. The project staff regularly follow up on our activities, especially on maternal and newborn health services and ROUSG services, which has been very supportive.”
For Krishna Bahadur Basnet, the HFOMC Chairperson, the change reflects something larger than a building. “The equipment provided through the project has greatly improved the functioning of the health facility and has made it easier for staff to deliver quality care,” he said. “We are very thankful to OHW and DDS for their continuous support and guidance, which has strengthened both the facility and our ability to serve the community effectively.”
When OHW first engaged with Shibarath Health Post, many mothers were unable to receive care in a safe and respectful environment despite the demand for institutional delivery. Today, the collaboration between OHW, the Dalit Development Society, and Bagchaur Municipality has not only improved the physical infrastructure but strengthened the trust and shared responsibility that will keep this facility serving its community long after the project has moved on.
One hundred and four families have found that difference at Shibarath Health Post, and the community has made sure it will be there for every family that comes after.
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This story was documented during a joint monitoring and supportive supervision visit to Shibarath Health Post on December 22, 2025, involving representatives from the District Coordination Committee, Health Service Office, Bagchaur Municipality, the NGO Federation, and the Nepal Journalist Federation. This work was carried out in partnership with the Dalit Development Society (DDS), OHW’s implementation partner in Salyan District. Quotes are published with consent.
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A safe birth should never depend on where a mother lives. One Heart Worldwide works alongside the Government of Nepal to ensure every mother and newborn has access to quality care. Learn more at oneheartworldwide.org.
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