Bringing a new baby into the world is an exciting and nerve-wracking experience—no matter what your circumstances are. But for some families, sociocultural norms, access to proper birthing facilities and proper roads can be added to the list of concerns when it comes to providing for their little ones. Therefore, these reasons lead to maternal mortality rates and neonatal death rates in the context of Nepal. That is why newborn support packages exist. A newborn support package is an important supply for your baby’s wellness; it can make all the difference in ensuring that your baby has the greatest start possible. This article is about navigating a newborn support package- why it began, how it began, what to expect and who is eligible to receive them and how it possibly lessens the little stress mothers face post-delivery of their newborns.
Kailash Rural Municipality is a remote village where lack of awareness regarding safe motherhood is high. Despite the Nepal government providing free delivery services at government health facilities many mothers and their families often opt for delivering babies at home instead. Caring for a newborn baby may be rewarding and overwhelming. They require some necessities from the minute they are born to be healthy and happy. However, many families go to traditional healers for any health-related issues rather than visiting health posts. One of many reasons being unsupportive socio-cultural environment and sometimes negligence from the senior persons in the family. Of course, traditional healers seem nearer and more feasible for them.
Nepal’s geographical structures are not new to no one either. The tremendous diversity in geography plays an integral part in determining the speed of infrastructural development. With steep hills and difficult terrains already making conditions worse for pregnant and postpartum mothers, the monsoon season tops the list. Needless to say how challenging the whole scenario can be only to receive basic health care service.
The Family Health Division (FHD) of the Department of Health Services (DoHS) therefore initiated the Maternal Mortality and Morbidity Study (MMMS) in 1996. This study gave a better understanding of the causes of maternal deaths to be 71 % by direct causes (postpartum haemorrhage, obstructed labour, eclampsia, puerperal sepsis and abortion) and 29% by indirect causes and fortuitous. With 90% of the deliveries occurring at home, most of the deaths occur in the community (79%) and only 21% in the health institution. Similarly, since antenatal coverage is low since most deliveries occur outside a health institution and only 10 % of the deliveries are attended by trained personnel (most being attended by friends and relatives) most deaths take place during the postpartum period (62%). Similarly, the Needs Assessment done in 2000 (UNICEF) showed an overwhelming unmet need for basic essential obstetric care services- Ministry of Health and Population, Nepal.
Shangri-La Development Association saw the need in Kailash Rural Municipality (KRM) in the Makwanpur district. SDA needed to intervene and make life easier for these women in a somewhat possible manner. SDA started working closely with KRM making its presence in three wards- 3, 4 and 7 respectively in 2015/16. Under the National Safe Motherhood Program by the Nepal government, in the fiscal year 2072/73, it introduced the free newborn care programme. Aligning with the scheme of the Nepal government, SDA in light of changing social, economic and demographic dynamics in KRM, SDA with support from the Municipality, local health posts, and local stakeholders, initiated the Newborn Support Package. Often following its core belief of sustainable development, since then it has been swiftly moving towards step by step.
First and foremost, the idea behind starting the newborn support package was to encourage mothers to institutional deliveries, safe motherhood practices, maintain proper hygiene and sanitation and increase maternal and neonatal health and survival, particularly among disadvantaged and socially excluded people. As a move to encourage there are certain itineraries that these mothers need to follow to not miss a chance to grab the package. Mothers who have had their institutional delivery and visited health posts at least four times for antenatal care follow-ups are legitimately provided with support packages. The package includes a range of items. These include baby soap, baby shampoo, innerwear, petticoats for mothers, towels, body soap and shampoo for mothers, sanitary pads, nylon rope to hang clothes, nail cutters, mugs, buckets, combs, and other essential items. Each of these items has been carefully selected to ensure that both the mother and baby can maintain good hygiene practices, which are crucial for their health and well-being.
SDA built a birthing centre at the Village Development Committee (VDC) of KRM- Kalikatar. Taking tiny steps to big wins, SDA also added an ambulance service to the health post in Kalikatar. This was a necessary step to take because the Katunje Health Post of Kalikatar had insufficient room to implement safe deliveries. The need for a well-equipped separate delivery room was unavoidable. Thus SDA, in coordination with the local government, constructed a Birthing centre as a One Time Project (OTP) using Interlocking Brick technology. For anybody who goes through a critical condition and has to be immediately taken to hospital, the ambulance service gives a huge relief to the sick ones and their family.
In the fiscal years of 2022 and early 2023, SDA has provided about 80 Newborn Support Packages. source: SDA monthly reports of 2022 and 2023.
Apart from distributing support packages, the Health Team of SDA make sure they are not just handing over the essential items, also they are educating new mothers on the “Do’s and Don’ts” of the postpartum period.
Every time a pregnant mother visits the health posts available at KRM, the SDA Health Team addresses the challenges a mother and a child can face in the future. The SDA health team conducts regular meetings, training and orientations for Health Mother’s Groups (HMGs) and Female Community Health Volunteers (FCHVs). They provide education on the importance of family planning, birth spacing, breastfeeding, and proper nutrition, ensure a safe environment from toxic materials such as lead or asbestos, consume alcohol and cigarettes, provide counselling to create a better future for their newborns, and so on. They say when we educate the mothers, we educate entire generations. Hence, organising such educational programs for these mothers is also because SDA wishes to make a sustainable change in the system where the mother is well aware of her condition and can take care of herself and the baby. Another major benefit of accessing a newborn support package is connecting with other new and experienced parents in the community that can provide valuable advice and guidance throughout their parenting journey.
The Newborn Support Package is an example of how tailored interventions, particularly in low-resource settings, can give critical support to mothers and babies. The package can have a substantial influence on the health and wellness of new mothers and their newborns by focusing on the provision of required products and support for proper hygiene practices, and it can also assist to reduce neonatal morbidity and mortality. Overall, the Newborn Support Package is a thriving initiative of the Shangri-La Development Association that gives much-needed assistance to recently delivered women.
In short, preparation is key when it comes to taking care of a newborn and giving them the best start in life. It can be overwhelming to make sure you have everything taken care of, especially if socio-cultural tensions, poor road infrastructures, negligence of family members, poverty, illiteracy, inadequate healthcare facilities and less skilled health workers keep a mother and a baby far from birth preparedness. With an effort to provide help with a newborn support package, you can equip yourself with the basics and start on the path of parenthood with confidence. At the end of the day, while the road to parenthood can often be challenging, taking advantage of newborn support packages and involving themselves in awareness programs can help alleviate some of the stress and make their journey toward raising a beautiful baby much easier.
SDA’s goal is to promote safe motherhood practices and reduce maternal and neonatal death rates paving the way to meet the UN SDG goal 3- Good Health and Well-being. The UN targets to reduce the global maternal mortality ratio to less than 70 per 100,000 live births and end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births by 2030. SDA gradually but believes that one day there will certainly be sustainable development in Nepal and all countries.