Interim Guidance for RMNCH services in COVID 19 Pandemic 2077
Family Welfare Division
Department of Health Services
Ministry of Health and Population
Approved Date: May 21, 2020
This guide has been developed by the RH sub-cluster which reports to the Health Cluster at MoHP and will be updated as and when new evidences are available
Guiding principles for SRMNCH services:
1. Ensuring access to RMNCAH services while ensuring physical distance (social distance)
2. Early detection and timely access to emergency services for women and newborn with complications
3. Protection of staff and pregnant women/newborn from COVID 19, and minimizing cross infections
4. Ensuring availability of equipment and commodities necessary of providing SRMNCAH services (PPE, drugs, commodities)
5. Supporting service providers for their movement and phone interaction with pregnant women and mothers
6. Ensuring pregnant women, mothers and newborn for their movement for access to health services
This interim guidance for continuation of essential RH services includes overall guidance for program managers in Section 1 and guidance for specific services in Section 2
Guidance for Managers
For all services:
• Helpline is available for women to consult for problems during pregnancy and childbirth and for advice and accessing MNH, FP, SAS and Child health related services
• Ensure for health facilities to establish screening and triage of women visiting for all reproductive health services
• Ensure PPE at all health facilities as recommended in Annex 1.
• Pregnant or lactating should not be given duty at sites with possibility for direct care of COVID 19 cases (clinical care, sample extraction, emergency, ICU, fever clinic). Consider deploying the pregnant and lactating health service providers to support other activities such as education or training needs.
-All HP/PHC/hospitals including NGOs should provide ANC, delivery, PNC, SAS, child health and IMNCI, immunization and nutrition services as applicable.
• MNH providers will support mothers and newborn through ANC and PNC teleconsultation services. Pregnant women will be advised to come to the Health facility if necessary; home visit will be provided to Postpartum women and baby if necessary
• Health facilities need to follow up on postpartum mothers and newborns through phone on Day 1, 3, 7 and 28 and conduct home visit if necessary.
• All birthing centers, BEONC and CEONC sites should provide regular delivery services (C-section, complication management) for women without COVID 19 symptoms and ready to provide delivery service for women with COVID 19 symptoms when referral is not possible
• Provide short term family planning methods from HP/PHC/Hospitals/NGO clinics/Pharmacies.
• Surgical contraception will be deferred as per MoHP guidelines
• Supply of FP commodities (ECpills,Condom) in quarantine center exit point
• Ensure Condom boxes and condom supply in strategic location.
• Coordinate with kirana and hotels increase supply of condom and display the availability of condom in each shops (managers can supply the Condom in Kirana pasal for free distribution) but report should be kept how many supply in kiranas. Monitor regularly the availability in such stores/shops
• Manage tele health service for FP client and disseminiate this information in local catchment area/people with use of public media
• Routine SAS including MA, MVA, second trimester abortion and Post abortion care services including post abortion Family Planning services will be provided from listed health facilities and certified health services providers
• Managers in Palika to ensure availability of adequate PPE, drugs, FP, SAS, MA, MNH, Child Health and immunization related commodities and supplies including Misoprostol (Matri Surakshya Chakki), Clean delivery kits and Chlorhexidine for new born cord care. Ensure FP commodities are also available at listed MA sites.
• Relevant administrative officials/officers of provincial and local governments should issue clear directives/administrative orders that ensure easy and uninterrupted access to all SRH services including MHN, FP, SAS.
• All registered Chemists and pharmacists allowed to store and dispense MA drugs approved by DDA.
• Support and arrange transport and ensure availability of free ambulance services (ensure PPE for drivers and cleaning of ambulance) for referral services.
• Coordination and facilitation with local government for movement of clients/beneficiaries to the health facility.
Routine Antenatal care should be provided from all HP/PHCC/Hospitals
GUIDELINES FOR CONTINUATION OF ANTENATAL CARE FOR WOMEN WITHOUT COVID
➢ Ensure check-up and advice, supplementation, medications as per need or referral if necessary
➢ History and Physical check-up: usual physical check-up and request women to face opposite of you during check-up. Ensure to ask and check for pregnancy complication signs and symptoms and COVID symptoms
➢ Pregnant women should be counseled on (repeat this even you have already counseled her during tele ANC consultation):
o On COVID-19 infection prevention practices
o On breast feeding with COVID symptoms
o On birth preparedness and institutional delivery
o On danger signs (usual pregnancy danger signs and COVID – difficulty in breathing)
and where to seek care
o On how and when to use “helpline” and provide helpline number and your phone
o provide women with nearby ambulance number
➢ Additional to usual antenatal check-up and supplementation (deworming, Td, ect.), the antenatal women should be
a. provided with IFA tablets for three months
b. provided misoprostol tablet (3 tablets), Chlorhexine, and clean/safe delivery kit at 8th months (or earlier) of pregnancy in case she faces difficulty in reaching to health facility/hospital for delivery care
Guidance for Health Facility in-charge and service providers:
For More and Download PDF File Click Here.
१नयाँ आबमा कर्मचारीहरुको तलव बढ्ने सङ्केत / यस्ता छन् आधारहरु /
२महिनावारी सम्बन्धि पूर्ण जानकारी (समस्या, परिवर्तन , जिज्ञासा आदि )
३कोभिड महामारीले बढ्यो दक्षिण एसियामा बाल तथा मातृ मृत्यु
४समायोजन मिलानको प्रक्रिया अघि बढेको सम्बन्धि मन्त्रालयको सूचना /
५Health Education, Information and Communication (HEIC) Program in Nepal
६Syllabus for Undergraduate Common Entrance Examination (2020)
१निर्माणाधीन स्वास्थ्य सेवा केन्द्रलाई अर्थको १ अर्ब ८ करोड बजेट निकासा
१स्थानीय तहमा कामकाजमा खटाउने कार्य स्थगन गरिएको बारे सामान्यको सूचना /
१स्वास्थ्य सेवा ऐन, २०५३ र स्वास्थ्य सेवा नियमावली, २०५५ परिमार्जन सम्बन्धी सूचना
१सरकारले गर्यो स्थानीय तहको वर्गीकरण : तपाई बसेको ठाउ दुर्गम कि सुगम ?(७५३ तहको विवरण)
१स्वास्थ्यको स्तरबृद्दी सम्बन्धि स्वास्थ्य सेवा बिभागको सूचना २०७६
१प्राथामीक स्वास्थ्य केन्द्र (PHC) को परिमार्जित नयाँ दरबन्दी संरचना २०७६
१कर्मचारी समायोजन,सरुवा,बढुवा र रमाना भए पछी भर्ने पारिवारिक दैनिक भ्रमण भत्ता सम्बन्धि अभिलेख फारम ९०६ (साबिकको -१८९)
१कार्मचारीको विवरण अध्यावधिक गराउने सम्बन्धि सामान्य प्र. मन्त्रालयको महत्वपूर्ण परिपत्र