Landscape assessment of the availability of medical abortion medicines in India.

Background: Medical abortion with mifepristone and misoprostol can be provided up to 63 days' gestation in India. This accounts for 67.5 percent of all abortions in the country.

Respectful Abortion Care initiative: How a large-scale virtual training for providers in India increased knowledge of the new 2021 Medical Termination of Pregnancy Act.

Background: In a historic move to ensure comprehensive abortion care, India amended the 1971 Medical Termination of Pregnancy (MTP) Act in 2021, creating an unprecedented opportunity for accelerating safe, respectful, and rights-based abortion services. The Federation of Obstetric and Gynecological Societies of India (FOGSI), together with World Health Organization (WHO) India and the Ministry of Health and Family Welfare, set up a flagship initiative "Respectful Abortion Care" (RAC) to provide training to obstetricians and gynecologists on the new Act, and also address their values and biases.

Methods: Virtual training sessions were organized during the COVID-19 pandemic to disseminate the amendments made under the MTP Act and address provider values and biases.

Intersectoral Action for Early Childhood Development in India: Opportunities, Challenges and the Way Forward.

Nurturing care framework for early childhood development (ECD) focuses on five essential aspects of the holistic development of a child, which are interrelated and inseparable. This multidimensional approach to child development is dependent on contributions from multiple sectors, requiring the 'whole of government' approach. In India, the lack of a single multisectoral framework for ECD, narrow accountability to sector-specific outcomes, overlapping responsibilities of frontline workers, lack of leadership for coordination, and limited supervisory mechanisms result in fragmented service delivery.

Promoting Nurturing Care for Early Childhood Development Through India's Public Health System.

Implementing the nurturing care framework (NCF) for early childhood development (ECD) is essentially multisectoral, requiring coordination amongst all sectors and harmoniously integrating it within the existing contact opportunities in the health sector. This paper discusses the relative strengths, persisting gaps, challenges, and the way forward to implement nurturing care for ECD through the public health system. The vast network of frontline health workers and health facilities; community, home, and center-based service delivery; health and wellness centers located close to the communities have the potential to promote nurturing care.

India's Policy and Program Landscape for Early Childhood Development.

Despite continuous improvement in health and nutrition-related child outcomes in India in the last decade, sub-optimal developmental outcomes still prevail due to multiple risk factors. Overcoming these risks depends on a supportive policy environment and implementation across relevant sectors to achieve universal coverage for all children and their families, especially those at-risk and those already affected by developmental disorders/disability. Several national policies articulate the multi-dimensional and multisectoral vision for achieving early childhood development (ECD), focusing on the first 1000 days and reaching the most vulnerable children.

Integrating postpartum contraceptive counseling and IUD insertion services into maternity care in Nepal: results from stepped-wedge randomized controlled trial.

Background: In Nepal, 54% of women have an unmet need for family planning within the 2 years following a birth. Provision of a long-acting and reversible contraceptive method at the time of birth in health facilities could improve access to postpartum family planning for women who want to space or limit their births. This paper examines the impact of an intervention that introduced postpartum contraceptive counseling in antenatal care and immediate postpartum intra-uterine device (PPIUD) insertion services following institutional delivery, with the intent to eventually integrate PPIUD counseling and insertion services as part of routine maternity care in Nepal.

Humanitarian response to reproductive and sexual health needs in a disaster: the Nepal Earthquake 2015 case study.

This case study describes the health response provided by the Ministry of Health of Nepal with support from UN agencies and several other organisations, to the 1.4 million women and adolescent girls affected by the major earthquake that struck Nepal in April 2015. After a post-disaster needs assessment, the response was provided to cater for the identified sexual and reproductive health (RH) needs, following the guidance of the Minimum Initial Service Package for RH developed by the global Inter-Agency Working Group.

Optimizing treatment for the prevention of pre-eclampsia/eclampsia in Nepal: is calcium supplementation during pregnancy cost-effective?

Background: In Nepal, pre-eclampsia/eclampsia (PE/E) causes an estimated 21% of maternal deaths annually and contributes to adverse neonatal birth outcomes. Calcium supplementation has been shown to reduce the risk of PE/E for pregnant women and preterm birth. This study presents findings from a cost-effectiveness analysis of a pilot project, which provided calcium supplementation through the public sector to pregnant women during antenatal care for PE/E prevention as compared to existing PE/E management in Nepal.

Reducing Perinatal Mortality in Nepal Using Helping Babies Breathe.

Background And Objective: Newborns are at the highest risk of dying around the time of birth, due to intrapartum-related complications. Our study's objective was to improve adherence to the Helping Babies Breathe (HBB) neonatal resuscitation protocol and reduce perinatal mortality by using a quality improvement cycle (QIC) in a tertiary hospital in Nepal.

Methods: The HBB QIC was implemented through a multifaceted approach, including the formation of quality improvement teams; development of quality improvement goals, objectives, and standards; HBB protocol training; weekly review meetings; daily skill checks; use of self-evaluation checklists; and refresher training.

Novel ways of improving communication with members of health professional associations.

The International Federation of Gynecology and Obstetrics (FIGO) supported the Nepal Society of Obstetricians and Gynaecologists (NESOG) to help influence national health policy and practice through FIGO's Leadership in Obstetrics and Gynecology for Impact and Change (LOGIC) Initiative in Maternal and Newborn Health. An Organizational Capacity Improvement Framework, developed by the Society of Obstetricians and Gynaecologists of Canada (SOGC), was used to evaluate NESOG's initial baseline organizational capacity in 2010. Communication among NESOG members was rated as moderate (39%).