Nepal: Clean Delivery Kits Save Mothers, Children

KATHMANDU, Nepal, April 29, 2005 — Every year over 57 million women in the world give birth with the help only of an untrained attendant, a family member or no one at all, resulting in more than 400,000 mothers and infants dying every year and many more who suffer long-lasting health effects.

PSI has responded with clean delivery kits (CDKs) in six countries including Nepal, where the conditions are particularly striking — more than half of women receive assistance from friends or relatives that have not had training on deliveries and birth preparedness and only 13% receive assistance from a health professional.

Most birth-related infections could be avoided through use of the simple tools found in a CDK: a clean razor blade and two clean strings to tie and cut the umbilical cord; plastic sheeting to provide a clean birthing surface; soap; and pictorial/written instructions.

CDKs are not a new product to Nepal. The kit was originally a project of Save the Children/US with technical support provided by current PSI/Nepal Country Representative Steven Honeyman and PATH who along with the kit manufacturers Maternal and Child Health Products (MCHP) Pvt. Ltd. designed and launched the product. Before he joined PSI, Honeyman worked for 2 years on the start-up social marketing project in 1993-95 as a technical advisor for MCHP with support from USAID. Save/US, MCHP and Honeyman hosted now Senator Hillary Clinton's visit to Nepal in 1995 to review, in part, the CDK program.

Since its inception the brand has slowly grown to become a household name in Nepal with one in ten home births using the Sutkeri Samagri CDK kit. The product is now endorsed and used extensively by a nationwide network of rural female community health volunteers (FCHV) — a large system of women that service the health needs of rural women. PSI absorbed the product in 2003 into its Nepal platform and now works with a local cottage industry comprised of women entrepreneurs to manufacture the product.

"Before we had Sutkeri Samagri we didn't really know what to do during birth… now we know… I remember I even used to put sacred cow dung on the cord wound to purify the baby. Many babies died back then… but not so today," recounts Mrs. Sangita Sharma, a FCHV from the mountainous Dhading District of Nepal.

A CDK intervention in Tanzania had significant success in reducing rates of infection, according to a 2004 study of 3,400 Tanzania women by the Program for Appropriate Technology in Health. Infants of mothers who used the kit were some 13 times less likely to develop cord infection and women who used the kit were about three times less likely to develop puerperal sepsis.

PSI/Nepal expects to sell in excess of 70,000 kits during 2005, which would yield more than 420,000 person years of protection.

In addition to Nepal, PSI markets CDKs in Uganda (Maama Kit launched 2001), India (New Born 2002), Pakistan (Clean Delivery Kit 2003), DRC (Délivrans 2005) and Laos (New Born 2005).

— David J. Valentine, PSI/Nepal

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