Nepal: Urban Health Center, Palpa

Support of Mother and Child Health Clinic

Formal Agreement Signed

Real Medicine Foundation signed a formal agreement with United Mission Hospital Tansen and began supporting the mother and child health clinics in June 2017. RMF’s support has revitalized the CHD, which had been declining due to lack of funds. RMF continues to support the mother and child health clinics with human resources and administrative expenses.

Services Provided

July-September 2017

The Mother & Child Health Clinic and the satellite clinics provide free services, including:

• antenatal and postnatal services,
• health education,
• family planning,
• PMTCT (prevention of mother-to-child transmission counseling,
• and immunization for mothers and children under 5 years of age.

The Mother & Child Health Clinic (town clinic) is located at the Palpa District Hospital in Tansen and is open from 10:00 AM to 5:00 PM, 6 days a week, Sunday through Friday.

The town clinic also provides training and observation opportunities for nursing students from Tansen Nursing School and Palpa Technical Institute.

The satellite mother and child health clinics operate monthly in the village health posts of Argali and Darlamdanda, working to empower and strengthen these local government health posts by providing orientation and training to health posts’ staff and also by providing much-needed medical equipment so that women and children in outlying areas can access health services that would usually be available only in cities.

Patient numbers declined somewhat in August and September due to the rainy season, which makes it difficult to conduct the satellite clinics because many roads are blocked by landslides. Inaccessibility during the rainy season is also a problem for the locals, who have to face many hardships to bring patients for check-ups and delivery in the hospital.

Indu Thapa

Health Education Session Utilized

Indu Thapa is a resident of Tansen Municipality, Palpa, and she completed her ANC check-ups as per the MCH clinic protocol. Indu had a cesarean section due to prolonged labor, delivering a baby boy at the United Mission Hospital Tansen. Her son, Lekha Bahadur, is now 4 months old. On each visit to the clinic, Indu voluntarily stays for the health education session so that she gets adequate information on health issues, especially on rearing and caring for children, as well as common childhood illnesses. She has continued to visit the Mother & Child Health Clinic for postnatal care and immunizing her son.

On this particular visit, Indu had returned to the clinic for her son’s second dose of the DPT-Hib-HepB vaccine. But the child had a low fever and was not ready for immunization. RMF Senior Registered Nurse Mana Laxmi Hemchuri counseled Indu on how to take care of the child: give him warm drinks and home remedies for a cold, keep him warm, and maintain hygiene. She advised Indu to bring the child back after a couple of weeks, but to bring him back immediately if his condition deteriorated. Indu followed the advice of RMF Senior RN Mana Laxmi Hemchuri, and when she returned to the clinic later, her baby was very healthy. He was given the second dose of pentavalent vaccine and Indu was counseled on other doses of immunization and the nutrition of her child. Indu is a very sensitive mother and very receptive to health education. Such citizens help to promote the health of society.

Bishnu Maya

Implant Removal in Hopes of Pregnancy

Bishnu Maya is a 30-year-old woman and a resident of Ripdikot Rural Municipality, currently living in Tansen Municipality with her husband and 5-year-old daughter. Her husband is a government official, and her daughter has started going to school. Bishnu does not like to stay idle, so she learned tailoring and now runs a tailoring business.

Bishnu had a normal delivery and is a responsible mother who would like to raise her child well and with a great deal of care. With this in mind, she decided not to become pregnant early again. Bishnu visited the MCH clinic soon after her daughter’s birth and hesitantly asked for advice. She was shy and hesitant at first, but once the MCH clinic staff counseled her about contraceptive methods and their advantages, she was glad that she came for advice and proud that she made the right choice. After counseling, Bishnu decided on an implant, which would be a hassle-free contraceptive for a comparatively long period of time. The staff also told her that the implant could be removed any time at her request.

Bishnu had the implant for 4 years, and as her daughter is growing up now, she desires to have another child. For this purpose, she wanted to remove the implant and visited MCH clinic again. RMF Senior Registered Nurse Mana Laxmi Hemchuri praised Bishnu for the decision and counseled her about the consequences of implant removal. She also removed the implant and asked Bishnu to visit the clinic in case of any problems or once she is pregnant.

Laxmi Adhikari

Contraceptive Counseling

Laxmi Adhikari is a 26-year-old woman and resident of Tansen Municipality. She was married seven years ago. Although Laxmi was satisfied, her husband could not find a good job in the country, so he went abroad in search of employment. He stayed abroad for 5 years and returned after earning a good amount to settle in his own country. Laxmi had just become pregnant when her husband went abroad, and she spent her time providing good care to her son. She visited the MCH clinic during her pregnancy and had a normal delivery at the United Mission Hospital Tansen. Laxmi also visited the clinic regularly to immunize her son and monitor his growth and development. Because her husband was away, she did not need any contraceptives. After her husband returned, she became pregnant again. She came to the clinic and followed all the protocols for ANC check-ups. Laxmi had a normal delivery for her second son as well, and she and her husband both were very happy.

Now Laxmi wants to provide good care to her second child too. She visits the clinic for timely immunization of her son and does not want to put stress on the family through an early consecutive pregnancy. So, Laxmi came for advice about contraception, and the MCH staff counseled her about every available option. She chose DepoProvera (depot medroxyprogesterone acetate) to be injected every 3 months. Laxmi was counseled well about 5 the possible adverse effects and the remedy for them. Once her child is grown up, she hopes to convince her husband to get sterilized. Laxmi appreciates the MCH clinic as a responsible health service that helps a lot of women pursue the good of their family and take good care of their children’s health as responsible mothers.