Baglung is a hill district in northwestern Nepal, which covers an area of 689 sq mi / 1,784 sq km and has a population of 278,259. Baglung reports 7,400 pregnancies per year. Before the implementation of the OHW program in 2010, the few existing maternity services that existed were severely underutilized; about 90% of all deliveries occurred at home, and less than 20% of all deliveries were attended by a skilled birth attendant. As a result, both maternal and neonatal mortality rates were twice the national average. After five years implementing the Network of Safety, the rate of deliveries with a skilled birth attendant was doubled, and the maternal and neonatal deaths were reduced to zero. We started our transition phase to the local government in 2015, and are looking to phase out at the end of 2017.
In 2015, the government of Nepal changed the definition of appropriate antenatal care (ANC) visits to state that only visits at four, six, eight, and nine months of pregnancy would be counted toward receiving “appropriate ANC.” Prior to 2015, all women attending at least four visits were counted as receiving appropriate ANC. The decline in this indicator can be observed across Nepal.