The number of home births in Nisdi Rural Municipality of Palpa has become zero. The number of home births in this municipality has become zero in 2081/82. There have been no home births in the current fiscal year either.

‘The current situation has come about due to the tireless efforts of health workers, public representatives, and community women’s health volunteers,’ said Rem Bahadur Disha Magar, head of the rural municipality’s health department. ‘There is support from all parties for this.’

Before 2074, the number of home births in Nisdi was 221. Only one person from the former Bankamalang, Sahalkot, Jhirubas, Mityal, Galdha, Archale, and Jyamire had undergone institutional delivery. The number of people who underwent pre-natal check-ups from 7 wards was 106. Even then, there were 63 female health volunteers and health workers in each health institution. But due to the geographical remoteness, the number of pregnant women giving birth in institutions was very low, said Magar, head of the health branch. By the fiscal year 2080/81, only one woman gave birth at home. That too, he said, happened when she went to work in the fields in the valley during the rainy season.

The maternal and child mortality rate in Nisdi rural municipality was also high until 2074 BS. According to the health branch, one or two stillborn babies were born every year from 2074 BS to 2078 BS. But since then, he said, there has been no such incident. The government established and expanded systematic birthing centers across the country under the Safe Motherhood Program in 2060 BS and started providing services through trained and skilled midwives. ‘Nisdi Rural Municipality has started a campaign to operate the safe maternal and newborn program in a systematic and effective manner and to reduce the rate of home births to zero,’ said Arjun Rana, Public Health Inspector of Nisdi Rural Municipality. ‘We have succeeded in creating a ward and municipality with full institutional maternity services.’

Birthing centers were already in place at Bankamlang in Ward 1, Mityal in Ward 4, and Archle in Ward 6 of Nisdi before 2074 BS. After the local elections, birthing centers were established at Sahalkot, Jhirubas, Jyamire, and Galdha health posts and safe maternity services have been provided by skilled obstetricians, said Mukt Bahadur Saru, Chairman of the Rural Municipality. ‘In addition, the municipality has arranged for egg distribution and nutritional allowance for pregnant women to promote safe motherhood,’ he said, ‘Those who are geographically remote are also being monitored through community health volunteers.’

Regular monthly health mother group meetings are held, transportation expenses are covered if they have to be sent to outside health institutions, and iron folic acid and calcium are distributed to pregnant and postpartum women, said Tiran Kumari Shrestha, vice-chairperson of the rural municipality. According to her, there is a women's representative program with postpartum mothers.

Under this, a woman's representative is present with the health worker when visiting a postpartum mother at home after delivery, and the municipality has been providing Rs 2,000 for nutritional expenses, said Vice-chairperson Shrestha. Some wards of Nisdi have also been providing facilities to pregnant and postpartum women in their own way. According to Durga Bahadur Somai, ward chairperson of Nisdi Rural Municipality-5, Galdha, a bank balance of Rs 8,000 has been started in the accounts of mothers and children who give birth at the Galdha Health Post.

In the last fiscal year, 165 people underwent regular pregnancy check-ups at health institutions, even after conducting a quick and easy survey in all seven wards. There is a laboratory in one health institution in Nisdi, and there is a birthing center in all wards. Due to the geographical remoteness, there are 5 community health units.

In the current fiscal year, the number of pregnant women is 294, while the population under one year is 244, according to the health department. There are 3,369 married women between the ages of 15 and 49. Since the number of home deliveries has dropped to zero since the previous fiscal year, all 7 wards and municipalities of Nisdi Rural Municipality have been declared municipalities with full institutional maternity services this year.

Lumbini Province Government has declared the local level and district with full institutional maternity services as per the criteria for declaring them as full institutional maternity services. District Coordination Chief and District Fertility Coordination Committee Coordinator Tankanath Khanal, Acting Chief of the Health Office Tuk Prasad Pokharel, Program Officer Bishwanath Neupane handed over the certificate of becoming a municipality with full institutional maternity services to the municipality.