Monday 28 March 2022

Empowering Women and Infants: My Journey in Making a Difference in Nepal's Health

Before embarking on my journey as a nurse in Australia, I had gained valuable experiential learning from grassroots women since 1996. This involved various roles and responsibilities in hospitals and development agencies, spanning clinical and community settings. As a result of my experiences, I decided to pursue a career in the public health field and applied for the Australian Development Scholarship in 2004, which I successfully secured.

Upon completing the Master of Public Health program at the University of New South Wales in March 2006, I returned to Nepal equipped with new analytical knowledge and a deep enthusiasm to make a difference in the development sector. I had focused my major project work during my master's program on the issues I was passionate about. Initially, I joined a private college as a lecturer for Bachelor of Public Health and Bachelor of Nursing students. However, I soon realized that I wasn't satisfied with my role and desired to have a direct impact on the lives of women and their families. I yearned for an opportunity to make a meaningful and selfless contribution aligned with my personal and professional interests.

One day, I came across the National Policy on Skilled Birth Attendants 2006, which emphasized the establishment of maternity hospitals and community-based "birthing centers" by mobilizing resources from the non-government and private sectors. These facilities were intended to serve as midwife-led training sites. Inspired by these statements, I took the initiative to form a group of 15 female health professionals and established the first nurse-led standalone birthing center, known as the Basic Maternity Service Centre, in 2007. Each of us contributed NPR 100,000 from our own pockets to make this endeavor possible.

After gaining nearly three years of firsthand experience in managing the center, I recognized the need to establish a professional association that could advocate for and engage with the Nepalese government to develop a midwifery workforce capable of providing leadership in midwifery. In 2010, I led a group of 11 nurses working in different institutions, representing both clinicians and educators, to establish the Midwifery Society of Nepal. Meanwhile, I also realized the need to enhance my leadership skills and explore gender power relations in sexual and reproductive health. In 2010, I applied for the Australian Leadership Award, strategically aligning it with my vision, mission, and objectives. I approached and requested Kiran Bajracharya, an academic associate professor at Tribhuvan University Institute of Medicine Maharajgunj Nursing Campus, to assume the role of President while assuring her two terms of three years each. I took on the role of Joint Secretary.

Before pursuing my doctorate program in Australia, I had the opportunity to secure funding from UNFPA and support the advocacy and lobbying activities for the initiation of a midwifery education program in Nepal. Subsequently, Nepal was awarded the global midwifery twinning project with the Royal College of Midwives (RCM) in the United Kingdom through the International Confederation of Midwives. In 2012, during my fieldwork in Nepal, I dedicated half of my time to research and the other half to advocating and lobbying with stakeholders to kickstart the midwifery education program.

Upon completing my doctorate program in April 2015 and returning from Australia, I engaged in relief work for the districts severely affected by the 2015 earthquake. During this time, I established temporary birthing shelters and continued my advocacy and lobbying efforts for midwifery. The Bachelor of Midwifery program was subsequently launched by Kathmandu University in 2016, followed by the National Academy of Medical Sciences in 2017, Karnali Academy of Health Sciences in 2018, and B.P. Koirala Institute of Health Sciences in 2021. Currently, there are 25 professional midwives in Nepal, a significant increase from none in 2010 when the association was established. In 2019, I assumed the role of President of the association.

From February 2016 to February 2020, I served as a board member of the Nepal Nursing Council, nominated by the Ministerial Council. The council serves as the regulatory body for both nursing and midwifery professionals, enabling me to work on the scope of midwifery practice, midwifery code of conduct, and the establishment of a national licensing examination for midwifery graduates.

Over the past 14 years, I have been dedicated to putting the government of Nepal's policy into practice, producing the critical human resource of midwives for safe motherhood. Empowering Nepalese girls and women has been my lifelong dream, starting from my involvement with the Women's Rehabilitation Centre (WOREC) in 1996. I believe that midwives, based on the global evidence spanning 300 years from Sweden to the United Kingdom, are the key professionals in the health sector who can bring about lasting change. Despite the challenges, I have been unwavering in my commitment to producing well-trained professional midwives in Nepal, and I believe this will significantly improve the lives of childbearing women and their infants, even beyond my lifetime.

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