Strengthening Health Systems & Improving Nutrition in Nepal and Vietnam


Reporting Organization:HealthBridge Foundation of Canada
Total Budget ($CAD):$ 4,206,323
Timeframe: March 17, 2016 - November 30, 2020
Status: Completion
Contact Information: Rebecca Brodmann
[email protected]

Partner & Funder Profiles


Reporting Organization


HealthBridge Foundation of Canada

Participating Organizations


  • Government and Public Sector

    • Foreign Affairs, Trade and Development Canada
  • NGOs

    • Center for Creative Initiatives in Health and Population
    • HealthBridge Vietnam
    • International Nepal Fellowship

Funders (Total Budget Contribution)


  • Government and Public Sector

    • Foreign Affairs, Trade and Development Canada (100%)
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Location


Country - Total Budget Allocation


Vietnam - $ 2,061,098.27 (49.00%)

Nepal - $ 1,892,845.35 (45.00%)

Canada - $ 252,379.38 (6.00%)

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Areas of Focus


Health - Total Budget Allocation


Nutrition (44 %)

Health Promotion & Education (19 %)

Health Systems, Training & Infrastructure (4 %)

Other - Total Budget Allocation


Law, Governance & Public Policy (27 %)

Economic Development & Empowerment (6 %)

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Description


The project ‘Strengthening Health Systems and Improving Nutrition in Nepal and Vietnam’ was implemented in two districts, Thuan Chau and Yan Chau, of Son La province, Vietnam and two Rural Municipalities, Raptisonari and Narainapur, of Banke District, Nepal. It was implemented from April 1, 2016-November 30, 2020. In both countries the project teams worked in remote and hard-to-reach areas where there is a severe lack of quality health services and infrastructure, and utilization of health services by community people is low. The local partners were HealthBridge Vietnam (HBV) and Centre for Creative Initiatives in Health and Population (CCIHP) in Vietnam and International Nepal Fellowship (INF) in Nepal.

 

In Vietnam, the highest rates of maternal mortality are in the northern mountainous areas, where Ethnic Minority groups generally live. Ethnic minority people tend to experience poorer health outcomes, few opportunities for education and are more likely to experience poverty than their Kinh, majority, counterparts. The Ethnic Minority groups most reached by the project are Thai and H’Mong.

 

In Nepal, the project worked in the mid-western Terai region. The mid- and far-western regions of Nepal fall behind on most indicators of mortality and access to health care services. Mothers and children in this region experience poor health outcomes and poor nutritional status. The project targeted marginalized groups, including religious minorities, in Banke District.

 

The project aimed to contribute to reducing maternal and child mortality in the targeted regions of Nepal and Vietnam. Research has identified that the first thousand days of a child’s life are critical for intellectual and physical development and lifelong learning. For this reason, the project team worked in collaboration with local governments to make essential health services and interventions accessible to pregnant and post-partum women and children under two years of age. The project aimed to strengthen the local health systems in both countries, contributing to sustainable improvements in health service delivery beyond the lifetime of the project. We worked with partners to improve health management capacity, improve delivery and access to quality health care and nutrition services, promote care-seeking and improve nutrition behaviours, and engaged with men and family members to reduce gender-related barriers to health for women and children.  A complementary goal of the project was to increase awareness and engagement of the Canadian public, researchers and practitioners in MNCH.

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Target Population


Gender and age: Adult women Adult men Adolescent females Adolescent males Under-5 children Newborns
Descriptors: Rural
Total Direct Population: 68,029
Total Indirect Population: 158,651
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Outputs


Unspecified

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Results & Indicators


Expected Results


The expected outcomes for this project are: (1) improved utilization of essential health services by mothers, pregnant women, newborns and children under two years of age in targeted sites in Nepal and Vietnam; (2) increased consumption of nutritious foods and supplements by mothers, pregnant women, newborns and children under two years of age in targeted sites of Nepal and Vietnam; and (3) increased active involvement of the Canadian public, researchers and practitioners in maternal, newborn and child health initiatives.

Achieved Results


Vietnam:

  • Husbands regularly accompanying their wives to antenatal care visits improved by 16%
  • The proportion of births at a health facility increased by 25%
  • The percentage of pregnant women who attended four antenatal care visits almost doubled
  • The percentage of women able to list at least three danger signs during pregnancy increased by 59%
  • Joint decision-making between partners about where to give birth increased by 18%
  • The percentage of women who gave birth at home assisted by a trained birth attendant, including Ethnic Minority Midwives, improved 7x
  • The percentage of newborns who received health checks within 24 hours of birth nearly tripled
  • The proportion of mothers who reported exclusively breastfeeding their baby for six months nearly doubled
  • The proportion of men who attended counselling during an antenatal care visit improved by 7%
  • The proportion of adolescent participants who could identify at least four negative consequences of early pregnancy improved by 12%
  • The proportion of households consuming beans and legumes, dark leafy vegetables, and yellow/orange fruits and vegetables increased by 19%, 10% and 12% respectively
  • Percentage of children aged 6 to 24 months who received a minimum acceptable diet increased by 16%
  • Percentage of children aged 6 to 24 months receiving vitamin A supplements improved by 12%
  • Percentage of newborns being breastfed within the first hour after birth improved by 25% 

Nepal:

  • The proportion of women who knew at least three danger signs during pregnancy increased by 14%
  • Percentage of deliveries in a health facility with a skilled attendant improved by 8%
  • The proportion of women and newborns who received postnatal care improved by 7%
  • The percentage of women who prepared a birth kit during their last pregnancy improved by 16%
  • Significant improvements in health facilities in terms of infrastructure, infection control and equipment
  • All health facilities in the project area now have 24/7 delivery care available
  • The proportion of men and family members who knew three danger signs during pregnancy, the postpartum period and of childhood illness all nearly doubled
  • Women reported that after attending the male engagement sessions, their husbands provided increased support during pregnancy and child birth
  • The proportion of women who consumed iron supplements during pregnancy increased by 17%
  • The proportion of mothers who knew about preparing super flour nearly doubled
  • 6,000+ households provided with vegetable seeds for kitchen gardens; 2,500 caregivers trained on kitchen gardening
  • Super flour was provided to the parents of nearly 3,000 acutely malnourished children

Indicators


SDG Goal 3. Ensure healthy lives and promote well-being for all at all ages
  • SDG 3.1.1 Maternal mortality ratio
  • SDG 3.1.2 Proportion of births attended by skilled health personnel
  • SDG 3.2.2 Neonatal mortality rate
SRHR-related Indicators
  • # of health care service providers trained in SRHR services
MNCH-related indicators
  • %/total of mothers, and %/total of babies, who received postnatal care within two days of childbirth
  • %/total of women attended at least four times during pregnancy by any provider for reasons related to the pregnancy
  • %/total of women aged 15-49 years with anemia
  • %/total of infants (0-5 months) who are fed exclusively with breast milk
  • %/total of health workers (male/female) trained and using their learned skills
  • # of health facilities equipped with maternal and newborn child health, or sexual and reproductive health equipment
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Sub Projects


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