New project launch: improving obstetric care for 10,000 births per year in Nepal
The Nepal Society of Obstetricians and Gynaecologists (NESOG) and the Global Surgery Foundation (GSF) are collaborating on a new 3-year project titled “Saving Lives of Mothers and Newborns in Nepal: Optimising Safe Surgical Care” (Nepal OSSC) in the Koshi Province in Nepal, with the financial support of the Else Kröner-Fresenius-Stiftung (EKFS).
The project aims to significantly decrease the morbidity and mortality of mothers and newborns through sustainably improving access to safe and timely surgical care in a network of hub-and-spoke facilities. The project is supported by SURGfund, the world’s first catalytic fund for surgical care.
Learn more on the project page.
Addressing a key gap in maternal health: access to safe surgical care for mothers
Emergency surgical obstetric care, including caesarean section (CS), is a lifesaving intervention for women and newborns. When conducted safely, timely, and for the right reason, CS can prevent nearly 100,000 maternal deaths globally per year and reduce neonatal deaths by at least 30%. However, women undergoing CS in low- and middle-income countries (LMICs) are 100x more likely to die compared to high-income countries, accounting for nearly a quarter (23.8%) of maternal deaths globally.
Current national data in Nepal indicates that CS is the most common surgery in the country and increasing every year. In Nepal, the national CS rate has increased from less than 1% in 1996 to 25% in 2023. In Koshi Province, the CS rate is 40.6%, indicating overuse. Moreover, based on the 2021 census report on Maternal Mortality, in Nepal, 38% of all maternal deaths occur following CS, clearly indicating an issue of surgical safety at CS.
“We look forward to working closely and in solidarity with our partner NESOG and the community to dramatically improve the health of mothers and newborns, and their experience of care, in Koshi by optimising caesarean section use and improving the safety and quality of caesarean section care when it is needed.”
Towards locally driven capacity building for better access to care for mothers
Launched in July 2024, the 3-year project titled “Saving Lives of Mothers and Newborns in Nepal: Optimizing Safe Surgical Care” (Nepal OSSC) will be implemented by the Nepal Society of Obstetricians and Gynaecologists (NESOG), in close collaboration with the Global Surgery Foundation (GSF) through its SURGfund mechanism.
Map showing the sites for the Hub and Spoke hospital sites in Koshi Province.
The project aims to build capacity and empower local surgical teams through an evidence-based approach, including capacity building, mentorship, enhancing safe surgical practices, and increasing operational performance, particularly regarding timely access to safe, respectful, and appropriate CS in decentralised settings.
Dedicated workshops and mentorship will be initiated and scaled up in one referral hub and three peripheral facilities in a “Hub-and-Spoke” model, developing a pool of at least ten mentors/trainers (2 interdisciplinary surgical teams) and build capacity of at least 50 interdisciplinary surgical team members (obstetricians/surgeons, anaesthesia providers, scrub technicians, nurse, and midwives). Through this, the project aims to improve the safety and quality of obstetric surgical care for more than 10,000 births that occur annually across the facilities. All facilities will also benefit from procurement of indispensable surgical supplies needed for safely performing CS.
“No mother and her newborn deserve to die in a natural phenomenon of pregnancy and childbirth. Through this project, we aim at a significant reduction in preventable maternal and neonatal mortality through optimizing needs-based, timely and safe surgical care. We do believe the collaboration between GSF and NESOG will be life-changing for the mothers and newborns of Koshi Province.”
A model to demonstrate and scale up impact for saving mothers and newborns
As an accompaniment of the capacity building interventions, a learning agenda as well as a comprehensive monitoring & evaluation framework will generate findings to build evidence of progress and impact that will be leveraged for transition and national scale-up nationally. This will be done in close collaboration with the Nepal Ministry of Health, the Provincial Health Directorate, health training centre, logistic management centre, public health lab, drug administration office, and 14 health offices in Nepal.
The expected impact for the project is as follows:
Increase clear clinical indication for CS to greater than 90%.
Decrease CS-related maternal complications (e.g. postpartum haemorrhage, infection) and death by more than 30%
Increase WHO Surgical Safety Checklist (SSC) use rate from 0% to greater than 90%
The first workshop for the project will take place in November 2024. This will be also the occasion to share key findings from a formative baseline evaluation led by and for professional communities in Nepal.
About GSF:
The Global Surgery Foundation is a non-profit foundation pursuant to articles 80 and seq. of the Swiss Civil Code and exists to facilitate and support the development of surgical, obstetrical and anaesthesia care systems that will ensure universal access to emergency and essential surgical care that is safe, timely and affordable. GSF works with governments and frontline providers to build surgical care systems that will save lives and decrease disability. As a common platform for global surgery stakeholders, GSF focuses on the low and middle-income countries which are furthest behind. GSF created SURGfund as the first and only catalytic funding mechanism for surgical care systems. Through this fund, GSF directly supports implementation and scale-up of projects with high impact on saving lives and building sustainable health systems.
About NESOG:
The Nepal Society of Obstetricians and Gynaecologists (NESOG) is the Nepalese professional society of obstetricians and gynaecologists, established in 1989, working with government, NGOs and INGOs to uplift the status of reproductive health of Nepalese women as an independent, non-profit oriented professional organization, consisting of 16 executive members in a total of 700+ members besides 9 honorary members.
About EKFS:
The Else Kröner-Fresenius-Stiftung (EKFS) is a non-profit foundation dedicated to the funding and advancement of medical research and the support of humanitarian projects. To date the foundation has funded around 2,600 projects. With an annual funding volume currently amounting to over 70 million euros it is the largest foundation in Germany that actively funds and supports medicine. You can find more information at: www.ekfs.de/en
The Nepal OSSC project is supported by GSF’s SURGfund, the first catalytic fund for surgical care systems.
Partner with us today to accelerate achieve sustainable impact on saving lives. Contact us at info@globalsurgeryfoundation.org.
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Learn more about the project here
This project is part of our Women’s Health Programme
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