Bring healthcare to thousands in rural Nepal

The Nepal Skilled Birth Attendant training program is a 2-month in-service training program for nurses, doctors, and midwives, to enhance the core skills and abilities for safe birth, which includes management of normal deliveries as well as potential complications.

Himalayan HealthCare in coordination with Bagmati Province Health Training Center carried out Skilled Birth Attendant (SBA) training for 8 Auxiliary Nurse-Midwives. These 8 young women auxiliary nurse-midwives (ANMs) undertook two-month training from 2 November to 31 January 2023 that enabled them to gain vital knowledge and skills to support the health of mothers and babies. Priority was given to Dalit/minority midwives while also including other midwives in the cohort. The selection was carried out by the health in-charge of each rural municipalities as per the (RM) requirement and priority of the municipality. The trainees were from 6 rural municipalities of Dhading district and was conducted at Bhaktapur Hospital in Kathmandu. The following are the list of participants: 

1. Somballaki S, Ruby Valley Rural Municipality
2. Namrata T, Gangajamuna, Rural Municipality
3. Sapana R C, Khanyabas, Rural Municipality
4. Soniya L, Khaniyabas, Rural Municipality
5. Apsara T, Netrawati, Rural Municipality
6. Sita K, Benighat Rorang, Rural Municipality
7. Anisha B, Gajuri, Rural Municipality

 The topics covered during the training

• communicate effectively with patients to provide women centered care
• history taking, perform physical examination and specific screening tests as required, including voluntary counseling and testing for HIV, and provide appropriate advice/guidance
• educate women and their families about the importance of making a birth plan (where the delivery will take place, how they will get there, who will attend the birth and, in case of a complication, how timely referral will be arranged)
• assist pregnant women and their families to make a plan for birth
• identify complications in mothers and newborns, perform first line management (including performance of life saving procedures and administer life saving drugs according to the national protocol when needed) and make arrangements for effective referral
• perform vaginal examination and interpret the findings
• identify the onset of labor
• monitor maternal and fetal well-being during labor and provide supportive care
• record maternal and fetal well-being on a partograph, identify maternal and fetal distress and take appropriate action, including referral where required
• identify delayed progress in labor and take appropriate action, including referral where appropriate.
• manage normal vaginal delivery
• manage the third stage of labor actively (using oxytocic drugs, clamping and cutting the cord, and applying controlled cord traction)
• assess the newborn at birth and give immediate care
• identify any life-threatening conditions in the newborn and take essential life saving measures including where necessary, resuscitation as a component of the management of birth asphyxia, and referral as appropriate.
• identify hemorrhage and hypertension in labor, provide first line management (including lifesaving skills in emergency obstetric care where needed),’ and if required make effective referral.
• provide postnatal care to women and their newborns and post abortion care where necessary
• assist women and their newborns in initiating and establishing early and exclusive breast feeding, including educating women and their families and other helpers in maintaining successful breastfeeding
• identify complications (illnesses and conditions) detrimental to the health of mothers and their newborns in the postnatal period and provide first line management according to the national clinical protocol, and if required make arrangements for effective referral.
• supervise non-skilled and semi-skilled attendants, including traditional birth attendants, maternity and child health workers and paramedics, in order to ensure that the care they provide during pregnancy, childbirth and early postpartum is of good quality
• provide advice, counseling and services on postpartum family planning
• educate women (and their families) on how to prevent sexually transmitted infections including HIV
• collect and report relevant data, collaborate in data analysis and case studies
• promote a sense of shared responsibility/partnership with individual women, their family members/supporters and the community for the care of women and newborns throughout pregnancy, childbirth and postnatal period
• use of vacuum extraction in vaginal deliveries
• perform manual vacuum aspiration for the management of incomplete abortion.
• repair of vaginal tears
• perform manual removal of placenta

The trainees are excited to utilize the skills and knowledge learnt during the training and impart services in the best way possible to the women patients and the community in their respective health posts. The photos are attached separately.