Target Groups and Services

Women, family, couple, child and adolescent friendly
APS is targeted to all women, children, adolescents, and families, especially poor and underserved families with middle-low and low-level income who reside around the Kalanki, Kriitpur, Thankhot. We also serve others from both inside and outside the Kathmandu valley who are unable to access costly maternity services in the private modern hospitals, maternity home and clinics. We aim to break the economic barrier to access and utilisation of maternal and child health services.

Services and Facilities

APS provides seven days a week, “women-couple-child-adolescent friendly” specialized reproductive health services by qualified and
experienced professionals, mainly nurses; the compassion, devotion and commitment of the nurses. Nurses give mothers the confidence and belief that they are receiving the best maternal and child health care and services, which is culturally sensitive and affordable to all families.

The specialization services available in APS from both the outpatient department and the inpatient department are listed below which cover almost all the areas of maternal and child health services. These include family planning services, maternal and child health care, birthing facility and proper referral services.

Outpatient Department (OPD)

APS Outpatient department provides maternal and child health services, reproductive health services, and well baby clinics that are run by trained nurses and Auxiliary Nurse-Midwives. The services include:

  • Antenatal and postnatal care
  • Family planning services
  • Safe abortion (Comprehensive Abortion Care and Medical Abortion)
  • Sexually Transmitted Infections management and counseling
  • Voluntary Counseling and Testing
  • Health education and counseling
  • Routine Immunization
  • Integrated management of childhood illness
  • Routine child growth monitoring for children under five years
  • Cervical Cancer Screening
  • Specialist Clinics (Obs/Gyn and Pediatric Consultation)
  • Treatment and management of minor injuries

The OPD opens from 6:00 A.M. to 9:00 P.M. Three days a week in the women’s health clinic and child’s health clinic which are run by specialists. The registration and booking for the outpatients is done at the main reception in the lobby area.

Inpatient Department (Birthing Centre)

As an inpatient service, APS has a 10 bed birthing centre, staffed by nurses and Auxiliary Nurse-Midwives, to conduct safe normal births for mothers in labour. Mothers are admitted only when the concerned nurse-midwife identifies it as a low-risk pregnancy and labour thus natural birth is likely. As per the Government of Nepal and World Health Organization’s protocols, a prerequisite for admission to the Birthing Centre is that a woman should have received antenatal care (at APS or elsewhere) and should have had routine antenatal tests: heamatocrit, blood ABO and rhesus grouping and syphilis serology. If these criteria are met, the admitting nurse-midwife performs a checklist screen that includes the findings of the history and examination. Women who are found to be at low-risk and confirmed to be in labour are admitted. Women who are determined to be a high-risk or who develop intra-partum risk factors, are referred to the hospitals.

Women who are admitted are taken care of very effectively for the proper natural birth of a baby. Dedicated and caring nurse-midwives nourish these mothers. Round the clock attention is given until the mother is discharged from the birthing centre. A birthing center presents a more home-like environment than a hospital labour ward, typically with more options during labour: food/drink, and the attendance of husband, family members and friends if desired. The decor is meant to emphasize the normality of birth. In a birthing center, women are free to act more spontaneously during their birth, such as squatting, walking or performing other postures that assist in labour. Active natural birth is encouraged.

In a birthing centre, a woman could have her own advocate, such as her husband, mother, sister or friend, with her to provide support before, during and after the childbirth. The nurse-midwives monitor the labour and the well-being of the mother and foetus during the birth. Should additional specialist medical care be required, the mother can be transferred or referred to another hospital or call an obstetrician.

Referral Service

A free-standing birthing center requires hospital backup in case there are complications requiring more complex care. Recognising this need, APS has establish close collaboration with Patan Hospital and Paropakar Maternity and Women’s Hospital, Thapathali for transfer or referral in case complications arise that require specialist medical care.

At the community level, community mobilization by the community health service team that consists of community volunteers (Female Community Health Volunteers), mothers group, local community based organizations (CBOs) and clubs, and APS Volunteer provide community empowerment, awareness raising activities, education and social marketing of the services.

Diagnostic Services

Laboratory facilities for basic investigations including ultrasound and pharmacy are available within the APS building. These are managed by trained technical professionals to ensure that the mothers do not have to leave the premises for an investigation.

Emergency Unit

Emergency obstetric care services are available round the clock, seven days a week. The qualified, experienced and dedicated duty nurse-midwives render the obstetric services and nursing care to the mother and her baby. Consultants are available in case the need arises.

Ambulance

At present ambulance service is provided only by request. However, there is a provision for an immediate transfer to the hospitals if referral is need. A nurse-midwife team is provided in case of emergencies for prompt obstetric care.

Home Visit and Follow-up

Nurses, APS health volunteers and other health professionals carry out regular home visits in the surrounding areas to raise awareness, educate and carry out social marketing of the services. To ensure continuity of care and services and effective follow-up, mothers will be reminded by phone or visited by an APS Volunteers and Female Community Health Volunteers.

Health Camp

International/National Women’s Day and National Women Festival “TEEJ” is a biannual event. At this time, specialists run a free women’s health camp especially targeting poor and underserved areas, coordinating with local community based organisations and women’s groups. In addition, when these organisations request additional camps, these are organised as required.

Vaccination

Vaccination services are provided for preventive care on weekdays from 6:00 A.M.-9:00 P.M. The following vaccines are available except for BCG (first Saturday of every month ) and Measles ( first Thursday of every month).

  • Tetanus Toxoid (TT) for pregnant women
  • BCG
  • DPT/Hep B/Hib
  • Oral Polio
  • Measles


Professional services and training

1. On-the-job and field placement training to nursing students and individuals
2. Research and Study Awareness Raising Activities

  • Orientation to women’s groups, school adolescents and local community organisations
  • Publishing in newspaper columns concerning reproductive health and safe motherhood
  • Coordinating with nursing colleges to mobilise nursing students for health teaching