2019 Annual Report (5)

due to falling off trees. Given that the NepahlEHR is the first point-of-care digital system to be implemented at the public
healthcare facility in Nepal, there is instant digitization of impact data. The hospital is also focused on chronic diseases,
injuries, and behavioral health.
THE BAYALPATA HOSPITAL BIRTHING UNIT AND
GYNECOLOGICAL SERVICES
The Hospital provides comprehensive Obstetrical care
including intrapartum, postpartum, contraception,
abortion-services, as well as antepartum and prenatal
care. For the most part, these services are provided by
the SBA (skilled birth attendant) and the General
Practice MD (mostly stepping in when a Cesarean
Section is needed) at the hospital. Some of the prenatal
and postnatal care is provided by the Community
Healthcare Worker (CHW) in the home and in group
settings. Prenatal Care provided in the group setting is
innovative and data-driven to provide culturally
appropriate care that allows for community building
amongst the participates. Women enjoy the aspects of asking questions and getting input from not just their care providers
but from the other women in their prenatal group. Group prenatal care has shown to improve health outcomes for mothers
and babies in studies and we were surprised and excited to see that Possible Health was integrating group prenatal care
into their model. This is a model that many health systems in the United States are utilizing, including the Denver Health
System, where Jenny Baxter is employed. We were surprised and thrilled to see that Possible was doing this.
Skilled Birth Attendants attend most births in Nepal and have significantly less training than is the standard in places like
the United States. The training is similar to an LPN (licensed practical nurse) with 8 additional weeks of training specific to
birth. To compare, CNMs (certified nurse midwives) in the US are Bachelors-prepared nurses with a minimum of 3 years
of additional training that is typically a Masters degree. With that said, as the SBAs become experienced over time and
receive ongoing training, they are invaluable for providing care and are providing much-needed services to women
throughout Nepal. The maternal and neonatal outcomes are markedly better in the hands of a skilled birth attendant.
?One of the highlights of my trip was the time I got to spend with the SBAs doing a drill-based training session on shoulder
dystocia, which is an obstetric emergency. I was so pleased to see
that the SBAs were engaged and excited to learn and to share their
own accomplishments and struggles. They were bright and willing
to work on practicing the maneuvers; they asked pertinent
questions and seemed to work well as a team. The staff is
accustomed to having an education session every day. This is
unique and is a wonderful culture for learning and dissemination of
information. I applaud this practice and wish, myself, that I had this
opportunity?.
- Jenny Baxter, Nurse / Midwife in Denver, CO
The hospital is a center of excellence and serves as a
demonstration for how things can/should be. The Obstetrics unit
was busy and well-staffed and with some small changes, it could
also serve as a beacon for OB care in Nepal. The WHO advocates
for a woman-centered, dignified approach to creating a birth
culture.
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