The Maternal & Neonatal Health Program

• Overview
• Goals
• Activities

Overview

Improving the maternal health situation in Nepal is an important priority because maternal death is the largest cause of death for women of reproductive age. The 1996 Nepal Family Health Survey (NFHS) estimates that 539 women die for every 100,000 babies born.

Goals

Initiated in October 1998, the Maternal & Neonatal Health (MNH) Program is a 5-year USAID-funded global initiative to increase the survival of mothers and their newborns. Its mission is to provide technical assistance to increase access to, demand for and use of life saving care for mothers and newborns. The MNH Program is implemented by JHPIEGO Corporation (www.mnh.jhpiego.org) in collaboration with JHU/CCP, CEDPA, (www.cedpa.org) and the Program for Appropriate Technologies in Health (www.path.org) in eleven countries worldwide.

Health Worker facilitating group discussion.

The Maternal & Neonatal Health Program began its work in Nepal in June 1999. A two-year plan of action was developed with approval of Family Health Division and USAID/Nepal. MNH/Nepal works in strategic areas of focus at the national level to support the National Safe Motherhood (NSM) Program of His Majesty's Government of Nepal (HMG/N) in its efforts to promote maternal and neonatal survival. Working through the Family Health Division, MNH/Nepal is collaborating with a variety of government partners, international non-governmental organizations (INGOs) and NGOs to achieve its objectives.

MNH/Nepal's goal is improved pregnancy outcomes for mothers and their newborns. MNH/Nepal is employing 3 main strategies to achieve this goal:

1. Improve policy environment and coordination for safe motherhood;
2. Increase quality of safe motherhood services; and
3. Increase access to and demand for safe motherhood services.

MNH/Nepal works at the national level to strengthen HMG/N systems through technical assistance. Nationally developed tools, curricula, materials, and standards will be implemented at the district and community levels through collaboration with ongoing SM projects, NGOs, and INGOs that work at the district level.

By promoting timely seeking, reaching and receiving of care, Behavior Change Communication will contribute to the identification of delay promoting those behaviors, increasing awareness of the dire consequences of delays, and promoting messages that encourage timeliness.

Activities

SUMATA Campaign

The SUMATA (Care, Share, Prepare) Initiative was launched on March 8, 2002 in Nepal by the National Health Education, Information and Communication Center (NHEICC). SUMATA is a national safe motherhood communication initiative to increase awareness of danger signs associated with complications of pregnancy and childbirth and increase birth preparedness to save women's lives.

The MNH Program and Safe Motherhood (SM) partners have used a participatory, step-by-step approach to address strategically the Maternal Health situation in Nepal. Beginning in November 2000, SM partners participated in "Speaking with One Voice", a consensus building workshop that brought together representatives of local, district and national groups working in SM. SM partners then together developed a SM advocacy strategy, SM IEC/BCC strategy and SM messages.

Drama troupe promoting SUMATA.

Based on the IEC/BCC Strategy for Safe Motherhood, MNH Program partner Johns Hopkins Bloomberg School of Public Health/Center of Communication Programs worked with an advertising agency to develop the creative SUMATA concept to provide a Nepali-language based framework for the initiative. SUMATA encourages husbands and mothers-in-law, in particular, to CARE for the pregnant woman, SHARE love and affection, health information and her workload and PREPARE for childbirth and potential complications .

In Nepali, Care, Share and Prepare is SUMATA, an acronym which also is a word in itself and loosely means Auspicious Mother in Sanskrit.

SU – SUshar Garaun – Care
MA – MAya Mamata Badaun – Share
TA – TAyari Garaun – Prepare

The slogan for the initiative is "Pregnancy and Childbirth are Special - Make Them Safe".

Using the Enter-Educate approach, the SUMATA messages are woven into a multimedia initiative including radio spots and dramas, print materials, a television drama and community based street theater performances.

A five minute video highlighting the SUMATA Community level interventions entitled "Sumata: taking it to the streets" was produced. (You will need RealPlayer to view this video clip.)

SUMATA Materials

 SUMATA Logo - Care Share, Prepare

Banners

Women reading banners	Banners displayed at a health facility

Danger Signs Poster

	Illustration on banner promoting clean delivery and male involvement	Street theater reinforce messages of radio dramas in local languages

SUMATA Posters

Poster promoting 'care, share, prepare' - urban couple	Poster promoting 'Care, share, prepare' - rural couple	Poster promoting 'Care, share, prepare' - mother-in-law

The following radio dramas and street dramas have been developed and aired/performed reinforcing the messages of Care, Share and Prepare:

• Agenda-setting radio spots and seven six-minute SUMATA radio dramas were aired nationally on Radio Nepal.
• These radio dramas have also been woven into 15-minute radio magazine programs by the Nepal Safer Motherhood Program (NSMP) and are currently being aired through regional and community FM stations in Pokhara, Surkhet and Rupandehi districts in Nepal and in local languages including Tharu and Abadhi.
• A series of six radio dramas incorporating EOC messages were broadcast on regional and FM stations, targeting districts where EOC services are available. NSMP have supported translation and adaptation of the dramas for local broadcast.
• A 3 part tele-film Ashal Logne (Good Husband) was written, produced, directed and performed by Nepal's most popular duo MAHA (Madan Krishna Shrestha and Hari Bansha Acharya). It was aired on Nepal Television to critical acclaim, and will be distributed in NGO locales and on video-cassette.
• Street theater troupes have performed over 100 dramas based on radio dramas and adapted to local cultures in two districts reaching audience of more than 50,000.
• A variety of innovative print materials have been produced, including posters, lampshades, danglers, and prayer flags featuring the SUMATA images and messages of Care, Share and Prepare. Wide dissemination was achieved through partner collaboration.
• Billboards featuring SUMATA erected in Nepal's major Maternity Hospital in Kathmandu, Ministry of Health, and 16 rural districts
• SUMATA print materials used by NSMP at "Sasu Buhari Vela" Mother-in-law and daughter-in-law meetings, and adapted by local community-based organizations into own formats.

Women enjoying SUMATA drama.	Artist performing SUMATA drama.	Men enjoying SUMATA drama.

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