IFGH 2010: Qualitative Research Informs Equity and Access Programming for Safer Motherhood in Nepal

Before the Commission on the Social Determinants of Health (World Health Organisation 2008) championed equity and access, Nepal’s government was addressing these issues within its national safe motherhood programming.

Under an Increasing Access Strategy, Nepal’s Safe Motherhood Programme (1997-2004) commissioned research to articulate womens’ voices and inform efforts to improve equity and access for socially disadvantaged groups. Findings fed into programme interventions and strategies. Key Informant Monitoring (KIM) was introduced: a participatory research tool which elicits data on changes in perception and behaviour. The next Support to Safe Motherhood Programme (2005-2010) established an Equity and Access component based on a partnership network of civil society organisations. KIM was expanded and Baseline and endline Knowledge Attitude Practice (KAP) surveys conducted.

Qualitative research detailed caste and ethnicity-related social exclusion, indigenous beliefs influencing care-seeking, and gendered traditions as barriers to access. Results shaped culturally-compelling Behaviour Change Interventions. KAP results showed participatory processes and contested debates enhanced advocacy, community involvement and women’s empowerment. Based on contextual research, novel programmatic solutions are bringing transformative change to scale.

This safe motherhood programme experience is now shaping the Nepal Health Sector Support Programme (2010-2013) through a new Gender and Social Inclusion Unit at the heart of government.

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