Health and Access in the Himalayas

My view from work in the Kathmandu valley, overlooking the southern hills
My view from work in the Kathmandu valley, overlooking the southern hills

Hello! My name is Abby, an incoming second-year MPH student at UNC in the Global Health concentration. For my practicum, I wanted to experience public health work in the field. It was my priority to utilize my newly learned skills in public health to the benefit of my practicum site, while still being challenged and gaining skills that I could use in my career. I had the privilege of ending up in Kathmandu, Nepal. Having grown up here, I was all the more excited to return home and experience Nepal in a professional setting with the Nick Simon Foundation International in partnership with the Nick Simons Institute (NSI). NSI is a Nepali run NGO that works to innovate solutions in rural healthcare through training and hospital support and advocacy with the Ministry of Health and Population of the Nepali government. I will be assisting the Research, Advocacy, and Monitoring and Evaluation (RAM) team with Dr. Ruma Rajbhandari and Dr. Suresh Tamang.

This summer, I will be evaluating the qualitative and quantitative data for NSI’s Advanced Skilled Birth Attendant (ASBA) training program, culminating in a policy brief for the Nepali government. The ASBA training works to enhance the clinical skills of obstetric emergencies, specifically focusing on cesarean sections, in medical officers. The training has been designed in partnership with the National Health Training Center to fulfill the shortage of specialized human resources in rural Nepali hospitals where transportation in an emergency is often limited due to geography, infrastructure, and cost. Ultimately this work will inform government policy and the potential scaling-up of the program and the deployment of ASBA graduates.

Janakpur Hospital at sunset
Janakpur Hospital at sunset

Most days I come to the Kathmandu office, but I also had an opportunity for a field visit to Janakpur to observe the Minimum Service Standards (MSS) of a Secondary B hospital. It was an insightful experience that showed the differences between program plans and implementation. Although further work has not been finalized, I may assist in the development of a logic model for future monitoring and evaluation of NSI’s large Curative Service Support Program (CSSP) for the RAM team at NSI.

A full Thali plate with rice, lentils, veggies, ghee, aachar, and dahi
A full Thali plate with rice, lentils, veggies, ghee, aachar, and dahi

In my spare time I am catching up with family friends, eating all my favorite street food, refreshing my (very rusty) Nepali, and enjoying the heavy rains of the monsoon.

-Abby