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Posted by Astha Ramaiya

Bayalpata Hospital has recently been approved by the regional District Health Office to begin The Safe Motherhood Program, in which expectant mothers can be financially reimbursed for attending antenatal care (ANC) visits and delivering in the hospital. Given that Achham suffers from one of the highest maternal mortality rates in South Asia (nearly one in one hundred deliveries results in the death of the mother), this is an exciting development that stands to greatly benefit the women of Achham.


Funded by a collaboration between the UK Department for International Development (DIFD) and the Ministry of Health and Population (MOHP) of Nepal since 2004, the objective of the program is to “socially empower [women] to practice desired safe motherhood and newborn health behaviors leading to increased equity of and access to health services”. With 99.5% of the mothers delivering at home in Achham, this program will help in addressing social issues and attitudes that can act as barriers to women accessing antenatal care (ANC) and obstetrical health services, and thus, hopefully help to address the high levels of maternal morbidity and mortality here in Achham.

In order to increase utilization of maternal child health services, this program provides 1000 NRs (about $14USD) to women for delivering in the hospital, and an additional 400 NRs (about $5.50USD) for attending 4 ANC visits prior to delivery. Moreover, in an effort to incentivize health workers advocating for maternal child health, the program provides an additional 300 NRs (about $4USD) to the healthcare provider(s) responsible for the delivery. At Bayalpata Hospital, in order to promote team work and collaboration between the staff, all health worker reimbursements will be pooled together and reimbursed monthly, equally amongst all the midwives, health assistants, and doctors.

My colleague recently wrote a mortality review of a preventable maternal death that occurred at the hospital. By starting the Safe Motherhood program, Bayalpata Hospital hopes that we will be able to minimize the number of cases like this, whereby pregnancy itself is a risk factor for maternal death. This program represents yet one more step in our efforts to promote women’s rights and health equity in Achham, and we look forward to scaling this program at large.

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