Community Based Maternal and Child Health Care in Nepal : Self-Reported Performance of Maternal and Child Health Workers

Indira Basnett,S Chettry,S Clapham

doi:10.31729/jnma.411

Abstract

The performance of a sample of 112 refresher trained Maternal and Child Health Workers (MCHW) was assessed over a nine-month period, using a self-reporting questionnaire. The findings show that the MCHWs are providing obstetric services, including antenatal care, birth attendance and postnatal and newborn care, at community level and identifying complications for referral, but their productivity levels are very low, particularly in the remote hill areas, where they are most needed. In order to increase their effectiveness, greater emphasis needs to be placed on the creation of an enabling environment, both in terms of professional support and recognition at community level. This requires more technical and logistical backup and the promotion of greater awareness amongst women and their families about the importance of midwifery care and skilled birth attendance.

Highlights

Maternal and Child Health Workers (MCHW) were first introduced in 1993, based at Sub Health Posts (SHP) to serve the maternal and child health needs of communities
Services provided The table I shows total figures for the services provided by the 112 MCHWs over the period of the assessment, including antenatal care, birth attendance, postnatal and newborn care, and referrals
This is comparable with the findings of the national assessment,[12] which showed an average of 17 ANC checkups per MCHW per month

Summary

Introduction

Maternal and Child Health Workers (MCHW) were first introduced in 1993, based at Sub Health Posts (SHP) to serve the maternal and child health needs of communities. They are usually local women, who receive a three-month basic training, including theory and supervised clinical practice in an assigned hospital. In 2000, as part of the national effort to reduce maternal mortality, the Ministry of Health initiated a strategy promoting community based skilled birth attendance[1] to complement the strategy initiated in 1998 to increase access to EOC services.[2] This included extending the MCHW refresher training to increase the number of skilled attendants available in communities. As it is commonly referred to as refresher training, the term will be used in this paper, which reviews the findings from a self-reported performance assessment of 112 refresher trained MCHWs

Methods

Results

Conclusion