Reducing home deliveries: Nirmala’s impact in Waku

Nirmala is affectionately known as “Nirmala Sister” in Waku village. Born and raised in Waku, she completed her schooling and dedicated herself to community service by becoming an Auxiliary Nurse Midwife. She is now in charge of the Waku Health Post.

Nirmala Sister takes immense pride in the health improvements achieved in her village. She recalls a time when the absence of a birthing centre in Waku, led to a high rate of home deliveries with limited options for intervention.

Thanks to the support of Action For Nepal and AHF, the Waku Health Post has been transformed into a well-equipped birthing centre. However, the challenge persisted, with 18 home deliveries recorded alongside 15 institutional deliveries in 2022/23.

“My team and I have been personally visiting every house in the village each month, engaging with men, women, husbands, wives, fathers, and mother-in-laws. Our aim is to emphasise the importance of institutional delivery and the risks associated with home delivery. Convincing them is not easy, we have to use different strategies, as it’s challenging to shift their traditional mentality.”

Another major hurdle to reducing home deliveries is the village’s remote location. Pregnant women struggle to travel the considerable distance to the health centre, often hindered by their limited financial resources, not able to cover the cost of transportation.

To encourage more institutional deliveries, the health post team pushed for more maternity support from Mapya Dudhkoshi Rural Municipality. They initially said no – until Action for Nepal intervened. The Rural Municipality finally agreed and increased the funds for pregnant women coming to Waku Health Post – a change that has been a big help for local women.

Nirmala Sister praised Action for Nepal for their deep understanding of local contexts, proactive approach in addressing concerns, and effective collaboration with stakeholders. She emphasised that this played a crucial role in fostering connections between the community and the Rural Municipality, significantly benefiting the entire community.

In the past six months, there has been just one home delivery compared to 13 institutional deliveries. For Nirmala and the entire health post team, this signifies a substantial reduction—a long-desired outcome ensuring the health and safety of mothers and babies.

Nirmala is very grateful for the support for the Solukhumbu Women’s Health Project, funded by generous AHF donors and the Australian Government through the Australian NGO Cooperation Program (ANCP).

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