Ensuring Safe Birth Practices in Western Nepal


In conjunction with International Women’s Day, Direct Relief is pleased to announce a $30,000 grant to partner One Heart World-Wide for the renovation and equipping of two birthing centers as well as the training and equipping of a minimum of four skilled birth attendants to serve rural communities in western Nepal.

When mothers and infants have access to a safe clean delivery with a well-equipped skilled birth attendant, they have a much better chance of survival. By equipping two birthing centers in two of the most remote areas of Dolpa district—where a combined average of 350 pregnancies occur each year—we hope to save many lives, both among newborn infants and among their mothers.

In Nepal, the further a mother lives from an urban area, the more likely she is to give birth at home. It’s critical that these women who are unable to reach hospital-based settings for labor and delivery are able to receive care from a trained birth attendant, midwife, or community health worker.

Currently in Dolpa, less than five  percent of all women in the areas where the birthing centers will be located  have access to skilled care during birth. Many contributing factors, such as lack of roads, unavailability of transport, and long distances from settlements to the nearest clinic limit accessibility to trained staff in health facilities. As a result, poor birth outcomes are common.

In 2012, the maternal mortality ratio in Dolpa was 1,259 per 100,000 live births and the neonatal mortality rate was 79 per 1,000 live births. These are among the highest maternal and neonatal mortality rates in the world.

Moreover, birth is considered impure in Tibetan culture and women are forbidden to deliver inside their homes. Instead they deliver in the nearest animal shed in dirty and cold conditions, unattended by a skilled birth attendant. Not surprisingly, the lack of cleanliness, the lack of skilled attendant and the cold often cause many women and babies to die of easily preventable conditions.

To help more mothers and babies survive, this project will focus on equipping two birthing centers in the townships of Saldang and Ringmo in Dolpa district and the training and equipping of a minimum of four skilled birth attendants to serve these communities. The District Health Officer (DHO) of Dolpa District will assist One Heart World-Wide in identifying eligible nurses and health workers to be trained as skilled birth attendants. Once trained, the local government has agreed to employee them.

In addition to the two birthing centers where women can access basic obstetric care, the project will provide a functional referral system for emergency conditions, a postpartum observation unit (non animal shed) for mothers and newborns.


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