About 

One Heart Worldwide is a US-based NGO that strengthens the capacity of the local health system to provide equitable access to quality MNH care for pregnant women and newborn infants. They are currently engaged in a 5-year project with the Ministry of Health and Population in Nepal.

We spoke with CEO David Murphy and Executive Director, Surya Bhatta, about the important work being done in Nepal, the power of partnership, and some 'blue sky' thinking about how we can work together to ensure women and newborns in Nepal survive and thrive. 

How has One Heart Worldwide been working towards improving maternal and neonatal care in Nepal?

One Heart Worldwide strengthens the local health system in Nepal to provide equitable access to quality maternal and neonatal healthcare (MNH). Our approach involves training programs, infrastructure improvement, and community engagement through a health system-strengthening approach. We collaborate closely with the Nepali Ministry of Health and Population to implement prioritized program activities and best practices. We focus on building the capacity of maternal and neonatal service providers, enhancing the readiness of the health facilities, and improving the leadership and decision-making capacity of the local municipal governments. We do this through a participatory approach with the local government.

Are you able to estimate how many lives of mothers and newborns have been impacted by your work?

Since 2010, our interventions have benefited a 1.3 million mothers and babies in Nepal. This significant impact reflects our commitment to reducing maternal and neonatal mortality and improving health outcomes through targeted, evidence-based interventions. We especially focus on poor, rural, and marginalized communities who are not receiving the quality health services that are a basic human right.

How has competency-based education and simulation-based training contributed to better outcomes for mothers and babies?

Competency-based education and low-dose, high-frequency simulation-based training have been pivotal in enhancing the skills and confidence of healthcare providers, especially in rural Nepal, where access to quality maternal and neonatal healthcare is limited. By simulating real-life scenarios, healthcare workers practice and refine their skills, leading to better preparedness. These methods bridge the gap between theoretical knowledge and practical application in real work settings. In Nepal, tailored simulation-based mentorship programs have significantly improved MNH service providers' knowledge, confidence, and clinical skills, improving the quality of care and health outcomes for mothers and newborns at our program intervention sites. There’s research that supports this published in BMC Medical Education and the National Center for Biotechnology Information, which highlights the effectiveness of these training methods for achieving and maintaining high standards of clinical practice.

What are some of learnings from the simulation-based mentorship program?

The Simulation-Based Mentorship Program (SBMP) has highlighted the critical importance of continuous learning and hands-on practice for healthcare providers. The key learnings we’ve seen are: the value of peer-to-peer support and mentorship in building confidence and competence, the need for regular refresher training, and the effectiveness of adapting training to local contexts and resources. 

Despite challenges such as mentee dropouts and scheduling conflicts, the program achieved substantial success, significantly improving participants' knowledge, confidence, and clinical skills. Participants praised the program's comprehensive and practical course content, realistic training tools, and effective teaching methodologies. The program's success really makes clear the necessity of continued monitoring, refresher training, and stakeholder engagement to ensure sustained improvements in healthcare delivery and outcomes. There is a manuscript under publication, so keep an eye out for the published paper.

Do you have a personal story that has made your work feel especially meaningful?

We heard some really good feedback from a nurse and mentor, Anju Chaudhary, nurse-in-charge at Katari Hospital in Udayapur district, about the impact of the Simulation-Based Mentorship Program (SBMP) on her professional development. Anju told us how the hands-on experience with simulators has been transformative despite her many years of experience in both urban hospitals and rural health centers: 

"This is the best training I have ever had. It has significantly enhanced my knowledge in professional midwifery nursing, boosting my confidence and competence as both a mentor and a service provider. The training has been a completely new and invaluable experience." 

How are you able to institutionalize the projects and programs to integrate them into the health system?

At One Heart Worldwide, institutionalizing our projects involves a collaborative approach with key stakeholders such as the Ministry of Health and Population, technical divisions, centers, provincial governments, local health authorities, and our program implementing partners. We prioritize aligning our programs with national health policies and integrating our interventions into existing health systems. This includes providing comprehensive training and resources to local health workers and offering technical support to municipal governments to ensure they understand and address local healthcare needs effectively. Additionally, we actively share our best practices with federal and provincial governments, advocating for the integration of evidence-based practices into their annual budgeting and planning processes.

How can programs be sustainable over time to ensure that once a project ends, the work continues?

We focus on building local capacity, fostering community ownership and engagement, and establishing robust partnerships with government entities. By providing comprehensive training and engaging local stakeholders in decision-making processes, including cost-sharing and co-creating program priorities, we ensure long-term impact that endures beyond the project's timeline. We also advocate for the allocation of local resources to sustain and scale our successful practices.

How have you been able to coordinate efforts with multiple partners?

Effective coordination involves regular communication, shared goals, and defined roles and responsibilities. To ensure a unified approach, we establish strong partnerships with other NGOs, government agencies, and local organizations. Regular coordination meetings, joint planning sessions, and collaborative monitoring help us align efforts and maximize impact.

What do you see as some best practices for partnerships?

We collaborate closely with partners to amplify our impact by sharing knowledge, resources, and expertise. Joint training sessions, partnership reviews, and sharing of learnings are integral to our approach. We believe in maintaining clear communications, fostering mutual respect, and aligning on a shared vision. We prioritize coordination through regular updates and feedback loops, ensuring that our efforts are cohesive and effective. A true partnership entails working together towards shared goals, pooling resources, and celebrating successes collectively. Our journey in partnership has been marked by significant progress and the implementation of various initiatives driven by our mutual strengths. 

What is next for One Heart Worldwide?

We are entering a new program phase where we are targeting interventions at different levels of the government.  One Heart Worldwide and Laerdal Global Health are collaborating with the Federal and Provincial governments to revolutionize the training landscape for MNH providers. We aim to ensure that all new MNH providers be trained using our low-dose, high-frequency simulation-based methodology. We aim to partner with Laerdal Global Health to export elements of low-dose, high-frequency simulation-based MNH provider training to another geographic location beyond Nepal. Central to our strategy is deepening partnerships with organizations such as Laerdal Global Health, enhancing synergy, and maximizing the impact of our interventions. We aim to reach a broader audience through collaborative advocacy efforts and create a more substantial impact in Nepal and beyond. 

What change would you like to see in the next 5 years in Nepal – and in other countries struggling with high maternal and neonatal mortality?

In the next five years, we would like to see a significant reduction in maternal and neonatal mortality rates in Nepal. This can be achieved through strengthened health systems, qualified and well-trained health workforces, increased access to quality healthcare, and empowered communities. Our goal is for every mother and newborn to survive and thrive, regardless of their location or socioeconomic status.