1. Background
Strategies for improving maternal, newborn and child health are outlined in the eleventh five year development plan (2007-2012) for Nepal. A National Neonatal Health Strategy was endorsed in 2004. The strategy focused on delivering a core package of neonatal interventions at community and facility levels, and outlined the systems supports that would be required to deliver interventions. In 2007, an assessment of progress in the area of newborn health by the Department of Health Services (DHS) found that limited progress had been made in implementation of the strategy. Since most deliveries still took place in the home, the assessment recommended the development of a community-based approach to improving ANC, ENC and PNC. The timing of PNC visits in the strategy was on days 3, 7 and at 6 weeks – and it was recognized that this timing needed to be changed in response to increasing evidence that neonatal deaths occurred in the early postnatal period.
Maternal and newborn health activities are implemented by the Child Health Division (CHD) and the Family Health Division (FHD) of the Department of Health Services (DOHS) of the Ministry of Health. The CHD is comprised of three sections – nutrition, EPI and IMCI. The FHD is responsible for pregnancy, delivery and maternal care. These divisions collaborate with the National Health Training Center (NHTC) and Regional Health training Centers, as well as with the National Health Information, Education and Communication Center (NHIECC). Services are de-centralized to districts in Nepal. Community health volunteers are Female Community Health Volunteers (FCHVs).
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