State of maternal, newborn and child health programmes in Nepal: what may a continuum of care model mean for more effective and efficient service delivery?


Kc, A; Bhandari, A; Pradhan, Y; Kc, N; Upreti, S; Thapa, K; Sharma, G; Upreti, S; Aryal, D; Dhakwa, J; (2011) State of maternal, newborn and child health programmes in Nepal: what may a continuum of care model mean for more effective and efficient service delivery? Journal of Nepal Health Research Council, 9 (2). pp. 92-100. ISSN 1727-5482

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Abstract

The cost-effective interventions exist across the continuum of maternal to child survival at each level of the health system that can contribute to achieve the Millennium Development Goals 4 and 5. However, implementation inefficiency, low coverage and equity gaps along this continuum remain a serious challenge to Nepal's efforts to achieve these goals. This paper proposes a continuum of care model; discusses the readiness of policy and programs to provide high impact interventions across the continuum; identifies existing gaps in MNCHN programs; and recommends policy and program actions to improve coverage, equity, effectiveness and efficiency along the continuum of MNCHN service delivery in Nepal. The literature review includes systematic desk review, followed by discussions and deliberations amongst a group of professionals and MNCH experts in Nepal. Within the government health system in Nepal, a continuum of care approach is feasible, as policies and plans exist to ensure an integrated approach across the maternal to child care continuum. However, health programs largely remain vertically oriented. Achieving integration across the maternal to child continuum of care remains a challenge at each level of health system. An integrated system of program management for maternal, newborn and child health would be a feasible solution to enable an efficient and effective delivery of intervention packages. A collaborative and partnership approach to strengthen health systems, building managerial capacity, improving governance and engaging the private and civil sectors remains vital to achieve effective coverage and improve equity across the continuum of care.

Item Type: Article
Keywords: Child, Child Health Services, organization & administration, standards, Child, Preschool, Continuity of Patient Care, organization & administration, standards, Delivery of Health Care, organization & administration, standards, Female, Health Policy, Humans, Infant, Infant, Newborn, Maternal Health Services, organization & administration, standards, Models, Organizational, Nepal, Pregnancy
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Public Health and Policy > Dept of Global Health and Development
Research Centre: Maternal Health Group
PubMed ID: 22929837
URI: http://researchonline.lshtm.ac.uk/id/eprint/2534575

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