Health care providers’ perspectives on the content and structure of a culturally tailored antenatal care programme to expectant parents and family members in Nepal.

Background: In Nepal childbirth is one of the most vulnerable periods of a woman's life and knowledge about the normal birth process, as well as danger signs, could be a life-saving intervention. Antenatal care programmes are therefore particularly relevant in Nepal where women deliver on their own in rural areas as well as in facility and hospital settings. Aim: This study aimed to describe the relevant content and structure of a culturally tailored antenatal care programme in Nepal to be developed from the input of healthcare providers. Methods: Qualitative semi-structured interviews with 26 health care providers were analyzed using Elo and Kyngäs’ content analysis. This study received ethical approval from the research ethics committee at Dalarna University, Sweden, and the Nepal Health Research Council. Findings: The results present possible (1) content and (2) structure of a culturally tailored antenatal care programme. Content is comprised of (a) how pregnancy affects the mother and how her lifestyle affects the unborn child; (b) normal childbirth, complications, and preparations; and (c) postpartum period – parenthood, childcare, and breastfeeding. Structure is related to (a) programme leader and location; (b) participants; and (c) pedagogy. Conclusion: This antenatal care programme will be culturally tailored to empower women with self-confidence and their decision-making power may increase in the family system regarding their own and their children’s health and wellbeing. Clinical Application: This study can help those designing culturally sensitive antenatal care programs in Nepal

Strengthening the integration of midwifery in health systems; a leader-to-leader collaboration

Barriers and facilitators for quality midwifery care exist on different levels in the health systems. After decades of challenges and varied degrees of success, a stakeholder leader-to-leader collaboration could provide added value through knowledge sharing on how to integrate the midwifery cadre into an existing health system. Initiated by The Midwifery Society of Nepal, Dalarna University Sweden and MAMTA - Health Institute for Mother and Child India, a research network focusing midwifery has been formed. The background, purpose and activities of this network has been described in this News and Events paper