Community Based Maternal and Child Health Care in Nepal : Self-Reported Performance of Maternal and Child Health Workers

Abstract

The performance of a sample of 112 refresher trained Maternal and Child Health Workers (MCHW) was
assessed over a nine-month period, using a self-reporting questionnaire. The findings show that the MCHWs
are providing obstetric services, including antenatal care, birth attendance and postnatal and newborn care,
at community level and identifying complications for referral, but their productivity levels are very low,
particularly in the remote hill areas, where they are most needed. In order to increase their effectiveness,
greater emphasis needs to be placed on the creation of an enabling environment, both in terms of professional support and recognition at community level. This requires more technical and logistical backup and the
promotion of greater awareness amongst women and their families about the importance of midwifery care
and skilled birth attendance.

Key Words: Skilled attendance, enabling environment, performance.