2019 Annual Report (5)

In addition, over the last 5 years, OHW has successfully shared the Network of Safety with several other organizations
around the world. They have provided technical assistance to programs in China, Ecuador, Liberia, Mexico and Peru. One
Heart World-Wide works closely with the government of Nepal, partnering with the Family and Child Health Division of the
Ministry of Health.
OBSERVATIONS
As a Certified Nurse Midwife with 18 years of experience, Jenny offered invaluable maternal health lens during the site
visits. She is a fully licensed as a Clinical Nurse and Midwife in the United States. She takes care of women by providing
prenatal care, contraception (including IUDs and Nexplanon insertion), delivering babies, first assisting for Cesarean
Section, postpartum care, repairing perineal wounds in the immediate postpartum period, cervical cancer screening or
GYN visits. Jenny recently completed her master trainer certifications for HBB (Helping Babies Breathe), and HMS
(Helping Mothers Survive) which includes both the BAB (Bleeding After Birth) and the Pre-Eclampsia and Eclampsia
modules. Low Dose High Frequency (LDHF) training methodologies, like HMS and HBB, have been proven to provide the
greatest impact for birth attendants to learn life-saving skills.
It was clear that OHW is doing great work in terms of upgrading the standard of birthing centers throughout Nepal. They
work in close collaboration with government, and the government officials we met with were very proud of his partnership
with OHW. We were particularly impressed by the equipment including the portable ultrasound machine. OHW expressed
the need for additional training where Jenny Baxter can be very helpful. OHW hopes to train all of their staff in specific
techniques that Jenny is a certified master trainer of, and this could be a potential funding/project area for the Schooner
Foundation.
Jenny Baxter?s Insights:
As a visiting healthcare provider, I was impressed by the Baireni Birth Center and the professionalism was evident; the
staff was very proud of the safe environment they have created and the measures they take to keep the birth center
running smoothly. I would highlight the following:
- They were able to share quality measures and to show documentation of the improvements they have had on
safety and cleanliness. They utilized checklists which is a valuable tool in the healthcare setting and many
forward-thinking hospitals in the US know that this increases safety.
- The patient-care areas were clean and included details that made the environment inviting.
- There was emergency equipment and sterilization tools and supplies and the staff was able to identify the location
of the supplies.
- Despite the remote location, they provided both abortion and contraceptive services on-site and had protocols in
place for the safe use of medications.
- They utilized algorithms and checklists for emergency care and clinical guidelines for transport.
- An ambulance was available for transport.
- The Nepalese government is in the process of building a temporary housing structure to allow families that live
remotely to stay close by which thereby increases the chances of a facility-based birth.
- They had an U/S machine and an SBA that was trained to use it.
- The SBAs were engaged and eager to learn and had many clinical questions about how we do things in US; it
was evident that they were proud of their work and eager to advance their skills.
- The birth center was a resourceful place for the whole community to gather; more than anything, this is a key to
women seeking and receiving care for them and their families.
As is the case all over Nepal, the SBAs are highly dedicated professionals. The training they receive, while minimally
adequate, is not enough to handle more challenging clinical scenarios. They are also functioning in extremely remote
locations with only very basic equipment and little to no support staff. I was able to see that the SBAs wanted more
training in hemorrhage management and hypertensive emergencies because when given the opportunity- this was where
the queries centered when given the chance to ask me questions. How very insightful that those are two of the largest
contributors to increases in the Maternal Mortality Rate.
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