MOMENTUM is strengthening Nepal’s public and private health systems to increase the availability of high-quality health services for women, newborns, and children across Nepal.
Over the last two decades, Nepal has made significant strides in improving the lives of its people, especially mothers and their children. Despite these gains, landlocked, mountainous Nepal has some of the most rugged and challenging terrains, isolating many from the health care they need. This isolation has created wide disparities between urban and rural people’s access to essential health services, including voluntary family planning.
Together with the government of Nepal and local partners nationally and subnationally, MOMENTUM addresses challenges to newborn health, including strengthening Nepal’s systems for tracking maternal and perinatal deaths, improving health care for small and sick newborns, and identifying feeding practices during the first stage of labor. MOMENTUM also partners with Nepal’s private sector, including providers, facilities, and pharmacies, to increase access to contraception across the country, especially for young people.
Partnering to Create Policies and Practices that Improve the Care of Small and Sick Newborns
As of 2016, 12 percent of babies born in Nepal were considered smaller than average, and the same percentage weighed less than 5.5 pounds (2.5 kilograms) at birth.1 As part of MOMENTUM Country and Global Leadership’s work to advance the quality of care agenda globally and to improve quality of care at the country level, the project is partnering with Nepal’s Ministry of Health and Population (MOHP) to assess current practices for, barriers to, and enablers of the care of small and sick newborns. This assessment bolsters the project’s efforts to co-design, develop, and test country-contextualized quality of care standards for small or sick newborns, including feeding practices, that align with the country’s priorities and aims. This process builds on the national adaptation of the WHO’s 2020 standards for improving the quality of care for small and sick newborns in health facilities. MOMENTUM is helping to test the updated standards’ use and investigate how they can be implemented subnationally.
Strengthening Nepal’s Systems for Tracking Maternal and Perinatal Deaths
By counting the number of maternal and perinatal deaths and gathering information on where and why these deaths occurred, health systems, facilities, and health care providers can have the information they need to reduce preventable deaths. MOMENTUM Country and Global Leadership is partnering with the Family Welfare Division at the MOHP to strengthen the Maternal and Perinatal Death Surveillance and Response (MPDSR) system in Province 1. We are providing targeted capacity building to facility and provincial teams and suggesting strategies to strengthen their response and increase overall quality. We are also using a Behaviorally Focused Applied Political Economy Analysis (BF-APEA) to help Nepal identify systemic factors that contribute to and inhibit the effective application of MPDSR at a sub-national level.
Understanding Nutrition Practices During Labor
The WHO recommends that women at low risk for a cesarean section drink fluids and eat food during the first stage of labor. This behavior is part of better quality care for laboring mothers, which helps improve maternal and newborn health outcomes. However, there is little research on nutrition practices during labor in low- and middle-income countries to contextualize the global push to implement WHO’s nutrition recommendations. To respond to this gap, MOMENTUM Country and Global Leadership is conducting an assessment in Nepal to understand current nutrition practices during labor and make recommendations on how to help facilities adhere to WHO recommendations. MOMENTUM is also leading a comprehensive assessment to understand health providers’, mothers’, and families’ perspectives on current practices and barriers to breastfeeding and specialized feeding throughout a newborn’s care.
Expanding Access to Family Planning Through the Private Sector
The number of Nepali women using modern contraception is growing. Twenty-five percent of Nepali people who use modern contraception get their method from a private source, which makes the private sector an essential partner in expanding access to family planning.2
MOMENTUM Private Healthcare Delivery partners with private facilities and pharmacies in Madhesh and Karnali provinces to provide quality counseling on family planning methods and help them provide access to a full range of methods for their clients. This collaboration enables us to help private providers manage their businesses.
Creating Tailored Solutions for Youth Family Planning
Many young people ages 15 to 24 who want to delay or prevent pregnancy are not currently using any form of modern contraception, especially married adolescent girls and young women. Using a human-centered approach, MOMENTUM Private Healthcare Delivery partners with private providers in Madhesh and Karnali provinces in their efforts to reach youth with the family planning services they need. This approach is designed to adapt services grounded in the realities that young people experience daily, allowing providers to reach them more effectively.
Learn more about USAID’s work in Nepal.
- Ministry of Health Nepal, New ERA, and ICF. 2017. Nepal Demographic and Health Survey 2016. Kathmandu, Nepal: Ministry of Health, Nepal.
- Ministry of Health Nepal, New ERA, and ICF. Nepal Demographic and Health Survey 2016.
Last updated September 2022.