“ A maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management.

For most women around the world, childbirth and motherhood are normal and healthy experiences. However, for many mothers and newborns it can also mean death or long term illness resulting from preventable complications related to pregnancy and childbirth.

It has been estimated that every minute of the day, somewhere in the world, one woman dies because of complications that arise during pregnancy and childbirth. This results to almost 600,000 deaths annually. Of these, almost 90 percent deaths occur in developing countries, especially in Sub-Saharan Africa and Asia. In Nepal every year, 4, 500 women dies of pregnancy and childbirth related complications i.e. 12 women per day or one every two hours.

In Nepal, women’s health is not a priority within the family or even to the women herself. Women do not see the need to seek health care until their state becomes so serious that it interferes with daily work. Pregnancy is viewed as a routine condition that requires no change in habits or special care. 89% of the deliveries took place at home, usually under septic conditions. Many women delivers in fields far from their house and in some parts of the country, many women are traditionally confined to the cowshed. Most of the deliveries are attended by the family members or untrained traditional birth attendants. Only 8% of the deliveries are attended by the skilled birth attendants. Other barriers to women health care include poverty, distance to service facilities, lack of roads, lack of transport and lack of emergency services

By early 1996, Ministry of Health (MOH) had already developed National Safe Motherhood Policies, Plan and Guidelines, several IEC materials were developed by the NGOs and INGOs and one of the local NGO produced Clean Home Delivery Kits (CHDK) to be purchased by the families at an affordable price. Despite all the accomplishments, the MOH could not yet initiate the National Safe Motherhood Program effectively. There was a lack of coordination between organizations concerned with safe motherhood, and feelings of confusion and frustration within the government and development communities about how and where to get started.

On March 8, 1996, government, several NGOs/INGOs and individuals came together with the motive to empower people and organizations to generate popular support and political will for the sustainable social change on safe motherhood. On that day, a group of concerned organizations quite literally “ took to the streets,” marching along footpaths and through villages across the country to launch the first safe motherhood campaign, “Clean Delivery Day.” Women rallied, enacted dramas, played games, organized contest, gave speeches, displayed posters, handed out brochures, held discussions and demonstrated the correct use of simple live saving Clean Home Delivery Kit. The event organizer developed standardized messages about clean delivery, developed and distributed IEC materials, along with an activity guide to promote effective use of creative communication strategies such as street dramas, puppet shows, contests, exhibition and demonstrations. This first event involved a coalition of 26 organizations (government, INGOs, NGOs) and 75, 000 participants, reached 41 out of 75 districts, at $ 4,000 only.

This mass campaign garnered media attention and build trust and appreciation among the organizers to form the Nepal Safe Motherhood Network at the family and community level through national grass roots level campaign.

Since its inception in 1996, the Safe Motherhood Network (SMN) has been in the forefront of Nepal’s efforts to change the outcomes for mothers and newborns. It offers a pioneering model of how a multi-sectoral alliance of organizations and individuals can work together to effect change on safe motherhood issues at multiple levels.