From Challenges to Change: Empowering Liku Health Post for Maternal and Newborn Well-being

By Reena Khulal and Sudip Dhungel

Dolpa is home to one of Nepal’s most beautiful lakes, mountains and rare species. But the tough terrain also poses challenges for rural communities who still survive with low quality healthcare services.

Photo by Bibek Raj Shrestha

In the heart of Dolpa, a remote district in Nepal, lies the Liku Health Post, a lifeline for the local community. This health facility has faced numerous challenges over the years, but thanks to the support of WEC (Women Empowerment Center), changes are taking place to improve services for mothers and newborns, bringing hope to the local communities.

WEC is an NGO local to Dolpa and one of One Heart Worldwide's partner organizations.

Led by the Ward Chairperson of the Palika, Mr. Lalit Parsad Giri, along with the active participation of the HFOMC (Health Facility Operation and Management Committee) members, and service providers, the community launched an initiative to provide much-needed equipment to the Liku Health Post in Tripurasundari Municipality. OHW & WEC were the sole funders of a significant contribution of NPR 152,030.20 (USD 1158.86) made to ensure the availability of essential resources.

During our initial visit to Liku Health Post, it became apparent that they needed more equipment with better organization. The health staff was unaware of the required amount of equipment in each set, posing a risk to the lives of mothers and newborns, especially in emergencies. However, the Health Post has progressed since then, with major equipment sets now complete. The HFOMC members, who were previously unaware of the unit cost received by the health facility, have now gained knowledge about it and understand how to allocate the financial resources received effectively.

Critical problems we are addressing

OHW/WEC are transforming the poorly-equipped and under resourced Birthing Centers like Liku Health Post (pictured above). The challenges are still high but progress for quality MNH healthcare is underway.

In the past, women in this area of Nepal have faced significant difficulties during childbirth due to a lack of early detection for complicated pregnancies. However, thanks to OHW/WEC's support and the training provided to Dharmadevi B., a Senior Auxiliary Nurse Midwife (Sr.A.N.M.) at Liku Health Post, the available resources, including the RUSG (Real-Time Ultrasonography) machine, are now being utilized to their fullest potential. Early diagnosis of complicated pregnancies has become possible, leading to the prevention of maternal and neonatal complications. 

Lalit Parsad Giri, the Ward Chairperson, played a crucial role in facilitating the program and expressed his deep appreciation for OHW/WEC's contribution, acknowledging that it would motivate the staff and enhance the quality of services provided by Liku Health Post.

"Thank you, OHW/WEC, for your support to this health facility; I believe this will help improve the health of mothers and children of our village. I assure you that we will properly use this equipment," said Chairperson Giri.

The event, held on 17 February 2023, witnessed the active participation of various stakeholders, including the Ward Chairperson, HFOMC members, nursing staff, health facility staff, and the SMNHS (Safe Motherhood and Newborn Health Support) project advisor from Dolpa. Although the Municipality Chairperson, Mr. Jana Chandra Rokaya, and the Municipality Nursing Focal Person, Mrs. Sangita Budha, were unable to attend, they assured their participation in the upcoming BC (Birthing Center) equipment support program in Pahada Health Post, scheduled for the following day.

The event aimed to provide essential equipment to the birthing center, thereby improving the quality of services offered by Liku Health Post and enhancing maternal and neonatal health outcomes in the region. It was also an opportunity to raise awareness among the local community about the availability of high-quality equipment at the birthing center and to make the HFOMC accountable for the sustainable and proper utilization of these resources.

Capacity building: A key factor for bringing change

HFOMC members received orientation on the proper management of resources, unit cost analysis, and maternal incentives, all aimed at improving the quality of health services at Liku Health Post. Recognizing the high institutional delivery rates in the municipality and a remarkable increase in institutional deliveries, with only one reported home delivery in the past three fiscal years, OHW/WEC identified it for renovation support. An OHW engineer visited the Health Post in April 2023 to assess the requirements for the renovation.

WEC and OHW organized an event for equipment support at Liku Health Post.

The RUSG training provided to Senior ANM Dharmadevi Bohora has not only enabled her to identify and prevent high-risk pregnancies in remote villages but has also led to the provision of regular services to pregnant women through RUSG mobile camps, combined with ANC/PNC (Antenatal Care/Postnatal Care) services, throughout Tripurasundari Municipality. 

She expressed her gratitude to OHW/WEC for the equipment support stating, "Visiting this health facility recently, I am impressed with the working modality of OHW/WEC. I am now more confident and motivated to provide quality delivery services, as we lacked complete sets before."

Health workers, HFOMC members, and local stakeholders attended the equipment support event. The local community and health staff praised OHW/WEC's contribution and expressed gratitude for the support, believing it would significantly improve the quality of services.

Creating Hope for Change

Knowledge building and awareness activities are a core part of improving maternal and neonatal health services in Dolpa district.

Despite the challenging context and harsh geography, the Liku Health Post has consistently delivered commendable health services. The enthusiastic and motivated health staff, supported by an engaged management team, has achieved impressive targets, as evidenced by the HMIS (Health Management Information System) data. OHW/WEC's integrated monitoring has facilitated the self-identification of issues and needs within the health facility, further reinforcing the delivery of quality services.

With active and consistent efforts of OHW/WEC's community-level activities, mothers' knowledge about safe motherhood is steadily improving. The birthing center at Liku Health Post has maintained a streak of zero home deliveries over the last three fiscal years, a remarkable achievement given the challenges faced in the ultra-rural Dolpa District. The support provided by OHW/WEC will contribute to reinforcing and sustaining these efforts and achievements, ensuring better maternal and neonatal health outcomes for the local community for many years to come.

Reena Khulal, Dolpa District Coordinator, One Heart Worldwide

Sudeep Dhungel, Field Officer, Women Empowerment Center

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