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Government of Nepal

Ministry of Health and Population

Ramshahpath, Kathmandu, Nepal

Safe Motherhood Programme

The goal of the National Safe Motherhood Program is to reduce maternal and neonatal morbidity and mortality and to improve the maternal and neonatal health through preventive and promotive activities as well as by addressing avoidable factors that cause death during pregnancy, childbirth and postpartum period. Evidences suggest that three delays are important factors behind the maternal and new born.

Benefits:

Women and children can benefit from following services:

1.     Birth Preparedness Package and MNH Activities at Community Level

(Birth preparedness and complication readiness (preparedness of money, health facilities for the    delivery, transport and blood donors).

·       Key ANC/PNC services (Iron, Td, Albendazole, etc), self-care (food, rest, no smoking and no drinking  alcohol, including pregnancy and post-partum period), essential new born care, identification and prompt care seeking for danger signs during pregnancy, delivery, post-partum and newborn period

2.       Rural Ultrasound Program

3.     Aama and the New born Program

The Government of Nepal introduced demand side intervention in maternal health with the aim of improving institutional delivery. The Maternity Incentive Scheme was first such intervention, launched in 2005 and designed to share the cost of transportation to health facility. In 2009, in addition to transport incentive user fees were removed from all types of delivery care, known as the Aama Programme. In 2012, a separate demand side intervention called 4 ANC incentives programme (introduced in 2009) was merged with Aama Programme. In FY 2073/74, the free new born care programme (introduced in FY 2072/73) has been merged to the Aama programme. Aama programme in its current form is known as the Aama and New born programme and has the following provisions:

Mother and newborn can  directly benefit from the following services:

Transport incentive for institutional delivery: A cash payment is made to women immediately following institutional delivery: NPR. 1,500 in mountain, NPR. 1,000 in hill and NPR. 500 in Terai districts.

Incentive for 4 ANC visits: A cash payment of NRs. 400 is made to women on completion of four ANC visits at the 4, 6, 8 and 9 months of pregnancy institutional delivery and post-natal care.

Free institutional delivery services: A payment to the health facility for the provision of free delivery care. For normal delivery, health facilities with less than 25 beds receive NPR. 1,000;, while health facilities with 25 or more beds receive NPR. 1,500. For complicated deliveries health facilities receive NPR. 3,000;  for C-Sections (surgery) NPR. 7,000. Ten complications i.e. APH requiring blood transfusion, PPH requiring blood transfusion or MRP or exploration, severe pre-eclampsia, eclampsia, MRP for retained placenta, puerperal sepsis, instrumental delivery, and management of abortion complications requiring blood transfusion and admission longer than 24 hours with IV antibiotics for sepsis are included as complicated deliveries. Anti-D administration for RH negative is reimbursed NPR.5000. Laparotomy for perforation due to abortion, indicated or emergency CS, laparotomy for ectopic pregnancy and ruptured uterus is reimbursed NPR. 7000.

Incentives to health workers for deliveries: A cash payment of NPR. 300 are made to health worker attending all forms of deliveries viz: normal, complicated and caesarian section. This is to be arranged form the health facility reimbursement.

Free sick new born care: A payment to the health facility for the provision of free sick new born care. Health facilities are reimbursed for a set package of care cost viz: 'Package 0' no cost, 'Package A' NPR.1000, 'Package B' NPR. 2000 and 'Package C' NPR. 5000. Health facility can claim as high as combination of A+B+C NPR.8000, depending on medicines, diagnostic and treatment services provided.

Incentives to health worker for sick new born care: A cash payment of NPR. 300 are made to health worker providing all forms of service packaged. This is to be arranged form the health facility reimbursement.

4. Reproductive Health Morbidity Prevention and management Program

5. Management of Pelvic Organ Prolapse

6. Cervical cancer screening and prevention training

7. Obstetric Fistula management

8. Emergency Referral Fund

9. Nyano Jhola Programme

Eligibility Criteria:

The incentives and services are available to the Nepali citizen especially the pregnant mother and newborn

Required Documents:

Only the Nepali nationals are eligible for this service hence, a copy of the Nepali citizenship need to be presented to claim incentives and services under this programme.

Service Availability:

Available in all public health facilities  with birthing facility

Newborn are eligible to receive the free sick newborn care in the programme implemented major hospitals. The plan is to roll out throughout the country

If you wish to find out more about the programme, contact any of the following health facilities nearest to you -

District Health Office

District Hospital

Primary Health Care Centre

Health Posts

Programme implemented by:

Family Health Division

Department of Health Services (DoHS)

Teku, Kathmandu

T : +977 1 4262063

F : +977 1 4251173

W: www.fhd.gov.np