Improving Maternal, Newborn and Child Health in prioritized municipalities


Nepal has now restructured into federal system with structural and functional changes. There are 761 governments that include 753 local governments. Local government holds and exercise the legislative, executive and judiciary powers over the small geographical areas distinguished for administrative and political purposes to equalize the national interest. The constitution mandates to local government for 22 exclusive powers, and additional 15 concurrent powers to function at the local level. The major objectives of restructured local governments are institutionalizing a democratic and well-functioning government at the local level; delivering public services to the local communities in an efficient, effective and responsive way; carry out social and economic development activities to uplift the living standards of the people; and developing organic local democratic leadership at the grassroots level. They mean to transform societies from inability to ability, and incapacity to capacity.

One of key responsibility of the local government is provision of ‘Basic Health Services’ as mentioned Constitution of Nepal 2015. Basic health service package includes more of preventive and public health interventions compared to clinical services. For provision of those services just technical capability of health worker seems insufficient. Health is often ignored by local bodies stating it as technical areas and not put in priority during planning and budgeting. Either they lack knowledge and skills on better planning for development or they have their own vested interest in planning and budgeting while in many cases both are at one place. Even if they do plan for health, the plan is just based on mind games and self-interests that comes haphazardly rather than proper evidence-based planning. In real field scenario, the capacity of local government in evidence-based planning particularly for health is limited. They more often focus on curative components of health services, as results are visible in short duration. Most of them consider health as availability of health workers and medicines only, that puts public health interventions in the hindsight. In order to institutionalize the federalism and local governance, various institutions such as development partners (DPs), bilateral organizations, private sectors and individuals have been involved according to their interests. Their main contribution endured with financial support in project activities, capacity development, and infrastructure development. In line with this, UNICEF Nepal had also financially supported and partnered with prioritized local level government for improvement of maternal, newborn and child health. UNICEF Nepal partnered with Nepal Public Health Research and Development Center (PHRD Nepal) to technically support/facilitate their two activities of many others.  

Project Activities

  • Conduct Evidence based Planning and Budgeting in prioritized municipalities

  • Conduct and Implement Quality Improvement (QI) initiatives in hospital and health facilities

  • Provide Technical Assistance to conduct maternal new born and child health related training (including Health Facility Operation Management Committee Orientation)

  • Technical assistance to for supporting MNCAH (Family Welfare Division)

Working areas


Project timeline

March-December, 2019



 1. Conduct Evidence based Planning and Budgeting in prioritized municipalities


This three days workshop was built on earlier stakeholder consultations that identified appropriate measures of coverage of MNCH interventions through tracer indicators that could act as useful proxies for the health services’ role in working towards improving health services in the municipality. Key tracers and indicators were selected based on Tanahasi framework for the bottleneck analysis. The dimensions covered to analyse each programmatic tracers were commodity (availability of essential commodities to provide the service), human resource (availability of human resources), access (geographic accessibility), utilization (initial utilization of service), continuity (timely utilization and follow-up) and effective coverage (effective quality coverage). The program was conducted in organization of municipality for their active involvement which helps to take the ownership of the program which realize them to frontward the plan in upcoming municipality council; implying the success of the program.


In total, PHRD Nepal facilitated 24 workshops.


2. Municipality level Quality Assurance Committee Formation and Orientation


Based on prepared guideline, PHRD Nepal facilitated Quality assurance committee formation and orientation program at municipal level. Initially program was supposed to be of 2 days but this activity was shrunk into one day as municipalities didn’t have enough budget for two days event.


3. Technical assistance to for supporting MNCAH (Family Welfare Division)

Our one staff stayed full-time at Family Welfare Division to provide technical assistance to maternal, new born, child and adolescent health related activities of the FWD. He involved in various activities being conducted there and supported technically. The key activities in which PHRD Nepal has been part are –


  • ‘Free Newborn Care Program Review’ slides preparation and its analysis -compilation (Ongoing) > follow up each province and hospitals for the review slides, data entry in the compilation sheet
  • Preparation and regular update of Newborn and IMNCI slides
  • Supported in preparation of MNCI Annual Work Plan and Budget (AWPB) and budget entry in TABUCS
  • Supported in preparation of implementation guidelines, implementation and monitoring plan (for all federal, provincial and local level) regular tracking of the financial and physical progress
  • Prepared annual report of FY 2074/75 related to IMCI and newborn program
  • Prepared directory of trained health workers on CB-IMNCI, SNCU and FBIMNCI
  • Field visits: to support FB-IMNCI training (twice) and Comprehensive Newborn care (level II) training to Medical Officers (twice) along with collecting data on SNCU and newborn care.
  • Partially supported in Logistic inventory (due to lack of relevant human resources)
  • Assisted in planning and organizing of trainings including identification of participants and trainers
  • Preparation of financial and programmatic progress reports, logistic forecasting and quantification


4. Review of Evidence based Planning and Budgeting in Khatyad, Mugu

5. Quality Improvement Scoring, orientation and action plan preparation in Khatyad, Mugu