Closed Strengthening midwifery services in saving lives
My name is Laxmi Tamang and I am one of the founding members of Nepal’s first and only nurse-midwife led independent birthing centre, and the Midwifery Society of Nepal, established in 2007 and 2010, respectively.
Our birthing centre is struggling for the sustainability because we are not donor funded. During its establishment, each of 11 nurse members contributed $1333 to set up and run the birthing centre. We registered it as a social enterprise with the mission to provide round the clock quality cost-effective women-couple-child friendly basic maternal and child health services to urban poor families empowering nurses to work independently for the good cause and have had very good cooperation and collaboration with the government of Nepal. We receive family planning devices, vaccines from the government and also had signed Memorandum of Understanding with the Ministry of Health and Population to provide free maternity care to women who come to give birth in our centre as per the government of Nepal’s policy for Safe Motherhood.
We provide free maternity care to all women who come to give birth in our centre, as well as a range of sexual and reproductive health services to urban poor families; these include family planning, antenatal care, delivery, postnatal care, safe abortion care, immunization, sexually transmitted infections treatment and management, and free home visit to follow up postnatal mothers and many more.
In Nepal, despite the government and some of the donors agencies i.e. UNICEF, DFID/UKaid efforts in promoting birthing centers in achieving millennium development goals 4, reduce child mortality and 5, improve maternal health, however in the history of Nepal, birthing centers do not seem sustain due to number of reasons. So far, two birthing centers run by two major and renowned hospitals, namely Patan Hospital and Stupa Community Hospital have been closed down. Patan Hospital’s birth centre has been closed in 2006 after 11 years of operation.
Though we've established our centre initially visioning to expand in rural areas of the country but now we are also struggling to sustain and facing challenge to retain our qualified and experienced staff members. The main challenge that we are facing is relating to the payment of salaries and house rent. Though we've small pharmacy and laboratory services it is enormous challenge for us to generate income to make our initiative financially sustain. To operate the birth centre to provide 24 hours services currently we’ve 10 paid staff including three cleaners, and six junior Nepali graduate nurse paid volunteers. Our services are almost free. We charge very nominal registration fees like in government health facilities for our services and a maternity care is free, women do not have to pay for it. Though we don't want to close down our initiative however, because of the financial constraint that we are frequently encountering members get frustrated and come up with such ideas.
Early last year, all eleven founding members rigorously discussed and almost decided to close down the Centre because besides working full time in other institutions they couldn’t contribute their time voluntarily to do shift duties in the centre. Due to my founding Chairperson, who established the first birthing centre in Nepal in Patan Hospital in 1995 and I were the one who didn't want to close down and opponent their ideas. Therefore, seven members withdrew their membership and left the Centre. My Chairperson and I are committed and dedicated towards strengthening midwifery services in the country that’s why we are still exist and also took lead role for the establishment of Midwifery Society of Nepal. Otherwise, our birthing centre would have been closed down early last year and would add up with another sad stories of the birthing centre closing down and would proved that birthing centers in Nepal are no longer sustainable.
Maternal Health expert, Dr. Geetha Rana, Current Assistant Representative at UNFPA Nepal, who had worked and played a critical role in the establishment of Patan Hospital’s birthing centre in 1995 in her email dated June 26, 2011 stated that “Although there is not much I can to help, and it is stating the obvious-it would be a great loss if the APS were to close down. It embodies the spirit of independent midwifery in Nepal”.
Since May of this year, Julie-Ann Dowdell, an Australian Midwife has been volunteering at the centre, and at the same time carrying out her research on the perspective of consumers, staff and stakeholders towards the birthing centre.
We welcome your contriubtion and support by volunteering your time during your travel to Nepal to make our effort sustainable. We look forward to getting your cooperation.
Website: http://www. midson.org