Joint Monitoring Visit by Ministry of Social Development and Golden Community in Janakpur Provincial Hospital on Sustain

Joint Monitoring Visit

by Ministry of Social Development, Janakpurdham, Dhanusha
and
Golden Community

in Janakpur Provincial Hospital, Janakpurdham on

Scaling up Safer Birth Bundle Through Quality Improvement in
Nepal (SUSTAIN)

A joint monitoring visit led by Health Service Division of Ministry of Social Development (MoSD), Province 2 Janakpurdham, Dhanusha was conducted on 11-12 th October, 2020 in Janakpur Provincial Hospital, Janakpurdham with the objective to monitor the status of SUSTAIN (Scaling Up Safer Birth Bundle Through Quality Improvement in Nepal) project and to identify potential gaps in implementation of safer birth bundle. A Technical staff of Golden Community was present during the monitoring field visit and discussion. A semi-structured tool developed by Golden Community was used to facilitate the discussion. The discussion session was led by Chief of Health Service Division. After the discussion, information on the availability, relevance, and effectiveness of safer birth bundles was gathered using a similar semi-structured tool with assistance from Hospital Nursing Inspector and Nursing Officer.

The major highlights of the discussion were:

Dr. Ram Naresh Pandit shared – “data has shown that after implementation of SUSTAIN, maternal and newborn mortality rates have declined and breastfeeding especially early breastfeeding has improved. This shows that SUSTAIN project is working effectively.” and mentioned that -“Moyo is time-saving and also timely detection of complications the pregnant women in the labour ward and also shared all intervention of SUSTAIN are equally important but skill drill plays a vital role in improving the newborn outcomes.”
Dr. Jamun P. Singh mentioned that – “I always advocated for proving care with safety measures at the time of pandemic. Technologies like Moyo made monitoring easier at the time of COVID.” He also shared that “The role of each component can give better results. The contribution of skill drills in reducing perinatal asphyxia, one of the most common preventable morbidity is at the top.”
Ms. Soni Thakur mentioned that “SUSTAIN project has been effective because after the implementation of the project and through use of new technologies, the rate of stillbirth has declined from 1.6 to 1.4 and we have been successful in reducing maternal deaths too as well as progressing towards the target of maintaining 100% skin-to-skin contact.” And also shared that “During the management of third stage delivery, partograph was not filled in many cases due to insufficient number of staffs but after we received Moyo, it has been a lot easier as it records the data even in the absence of adequate human resources. We have also developed an action plan after a discussion at PDSA meeting… we have added that Syntocin should be given within one minute, APGAR should be measured in one minute followed by delayed cord clamping and also participate in regular skill drill session through repeated motivation from project staffs.”
Accordingly, Ms. Sandhya Das shared- “We are also receiving a simulation training at the moment, so, after the lab set-up, daily skill drills will be continued in the lab.” And also mentioned that “Attitude and behaviour of staffs had changed. For example: the number of delayed cord clamping cases are now- a-days registered…Staffs are concerned whether skin-to-skin contact is maintained and breastfeeding is initiated within one hour.”-
Participants shared that, SUSTAIN has helped in quality improvement of intrapartum care at the hospital through regular conduction of PDSA meetings and other time-saving interventions such as NeoBeat and Moyo. Since the implementation of SUSTAIN project at Janakpur Provincial Hospital, Janakpurdham, quality of intrapartum care has improved. With regular conduction of PDSA meetings, problems are identified and discussed for possible solutions. Skill drill sessions, mostly conducted with the help of project staffs, have helped in improving the skills necessary for newborn resuscitation. SUSTAIN is going well at this hospital through use of new technologies such as Moyo and NeoBeat.