जारी अनुसन्धानहरु

जारी अनुसन्धानहरु


Tracking and reviewing the work status of Advanced Skilled Birth Attendants (ASBA) training graduates in Nepal

Nick Simons Institute (NSI) has been providing technical and financial support to strengthen the various in-service training conducted by National Health Training Center (NHTC). One of the in-service training courses is “Advanced Skilled Birth Attendants (ASBA)”. The objective of the ASBA training is to enhance the skills regarding the management of obstetric emergencies primarily focusing on Caesarean Section (CS). Medical Doctors who have completed an ASBA course by NHTC is defined as ASBAs. They also assist MDGPs to perform CS and other essential surgeries. After completion of the training, graduates are supposed to be deployed at hospitals where CS service is available. As of 2076/77, about 234 ASBAs have been trained. The ASBA in-service training is initiated to fulfill the shortage of specialized human resources in a rural hospital of Nepal to manage obstructed maternal and neonatal health problems. Till now, limited study has been done to explore the status of those graduates. It is essential to evaluate whether the pregnant women have been getting CS services despite the absence of specialized health workers.NSI (Research, Advocacy and Monitoring Unit) is conducting a study to determine whether the ASBA graduates can fulfill the gap of human resources to provide comprehensive emergency obstructive care in rural hospitals of Nepal. This study will explore whether the purpose of training is achieved or not.  For this, we will look at the working status of ASBA graduates, investigate whether the ASBAs g...

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Factors Affecting the Success and Failure of Maternity Waiting Homes in Nepal

Maternity Waiting Homes (MWHs) are structures built at or near a health facility for pregnant women to stay at the end of their pregnancy so they can be transported easily to the health facility for delivery. MWHs were introduced in 1970s in order to create access to institutional delivery services. They were primarily utilized by the high-risk pregnant women who live far away from the health facilities. It can be an intervention aimed at eliminating the phase II delay by bringing women closer to facilities to deliver. It goes by many different names, but in general are accommodations at or nearby a health facility where pregnant women and accompanying family member can stay in the final weeks leading up to delivery.Nepal is an illustrative example of how MWHs can succeed and fail, and understanding the reasons for success or failure is imperative to informing the design and implementation of future MWHs in Nepal and elsewhere. The first 27 MWHs in Nepal were constructed by the Ministry of Health and Population (MoHP) with the support from UNFPA, none of which were found to be functional in a 2007 MWH feasibility study. Today, at least few MWHs are still operating in Nepal. In the FY 2075/76, the provincial government of Karnali (Province 6) of Nepal planned and implemented a program to operate maternity hostels (waiting homes) in all primary and tertiary hospitals with in the province by allocating some budget to offer a residential facility for the pregnant women in order to provide quality maternity care. There are few in...

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Minimum Service Standards scores versus health outcomes and perceptions in Nepal Government District Hospitals.

With health as a fundamental right, people in rural Nepal are becoming increasingly aware of their healthcare needs. Recent health policies and strategies in Nepal place a central emphasis on the importance of improving quality at the point of care. The National Health Policy commits Nepal to ensure access to quality health services: (1) Quality Health Services are identified as one of the strategic directions for achieving Universal Health Coverage (UHC) in the Nepal Health Sector Strategy 2015 – 2020. (2) Improving quality of care at the point-of-delivery is an outcome of the Strategy.This study will generate evidence towards the applicability of MSS as a measure of quality in district hospitals of Nepal. This will be accomplished by comparing the MSS scores in aggregate and domain-wise between the different hospitals with health outcomes data obtained from HMIS (Health Management Information System) as well as perceptions from patients, hospital development committees, and the community. This is the first study to describe MSS and its role in government district hospitals of Nepal.The primary objective of the study is to compare the MSS scores with health outcomes and to explore the user’s perceptions towards Government hospitals and quality of services. We hypothesize that the higher MSS scores in general are associated with better healthcare outcomes and better patient/community/hospital management perceptions. ...

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