Safe Motherhood and Child Care

Safe Motherhood and Child Care
Infant mortality is high in Nepal, around 50 deaths per one thousand live births. Although over the past few decades, Nepal has seen substantial improvements in its reproductive health outcomes, infant and child mortality as well as maternal mortality remain high compared to rates in other developing countries.  CDOhas initiated a program called Safe Motherhood and Child Care (SMCC), with the goal of reducing infant as well as maternal mortality through a number of health care and health education/training measures.  The program was begun as a pilot project in the year 2010for pregnant women/mothers in 20 brick factories near Kathmandu.  In 2013, this program was alsostarted in remote villages (Remote Village Outreach Program).

The program focuses on six topics:

1. Antenatal care.
   Monthly antenatal checkups for all pregnant women, along with immunizations, de-worming treatment, malaria prophylaxis (if necessary) and supplementation with minerals and vitamins are offered.
2. Delivery care.
   All pregnant women of the brick factories are encouraged to go to an appropriate health facility for delivery where 24 hour emergency obstetric services are available.  (The cost of this is covered by CDO.)
3. Postnatal care
   After delivery, the follow-up is done by CDO in form of three postnatal visits; medicines, vitamin A and iron supplements for the mother are provided as needed.  The mother is educated with respect to hygiene and nutrition.  For the infants, exclusive breast-feeding is recommended.
4. Newborn care
   Parents are educated on essential newborn care practices; initiation of breast-feeding within one hour of child birth is recommended.  In case of neonatal danger signs, timely referral to an appropriate health facility is arranged for.
5. Immunization
   The parents/mothers are being educated on the importance of childhood vaccinations.  Vaccinations, in combination with vitamin A supplementation and de-worming medication, are carried out in coordination with the local government health post of Nepal.A record of the vaccinations is kept, as well as notes of weight and height of each child.  A copy of the record book stays with the family.
6. Distribution and training on the preparation of Micro Nutrient Mix powder (MNMP)
   To encourage the mothers to present their children for vaccinations, packets of Micro Nutrient Mix powder are distributed, and small toys are given to all the children who come for vaccination.MNMP is a highly nutritious meal prescribed by the WHO especially for children1. Training is given to all motherson the preparation and preservation of MNMP from locally available products.

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The ingredients of MNMP  are:  Two parts pulses (Fabaceae or Leguminosae), one part whole grain cereal such as maize or rice, one part another whole grain cereal such as wheat, millet or buckwheat. The pulses and grains need to be cleaned, roasted well (separately) and ground into fine flour (separately or together). The flour can then be stored in an airtight container for up to three months.