Outcome 1: Health System Strengthening
Strengthened delivery of safe, hygienic, and reliable MNCH and family planning services through improved health system infrastructure, capacity, and coordination. 

Outcome 2: Service Quality Improvement
Increased access to high-quality MNCH and family planning services, enabling more women to utilize essential healthcare services effectively. 

Outcome 3: Community-Based Health Promotion
Empowerment of women to access sexual and reproductive health services—including family planning—through enhanced community engagement, education, and health promotion initiatives. 

Measures related to Outcome 1: Health System Strengthening

• Refurbishment of Facilities: Upgrade existing health infrastructure to provide safe, hygienic environments for two birthing centers, ante- and postnatal care, and secure storage of medical supplies. This includes provision of non-medical items, room partitioning, and necessary repairs.
   
• Provision of Equipment and Orientation: Supply essential medical equipment and consumables to Health Posts, and provide orientation to staff on their proper use to ensure safety and effectiveness.
   
• Training and Capacity Building: Train and support health workers and Health Facility
   
• Operation & Management Committees (HFOMCs) to help Health Posts meet the Government of Nepal’s minimum service standards. Focus areas include WASH facilities, infection prevention, waste management, birthing services, family planning, and maternal care. 

• Service Level Improvement Goal: By the project’s end, all Health Posts are expected to achieve at least 80% compliance with national minimum service standards, up from under 50%, with a commitment to reaching 100% within six additional months. 

  Measures related to Outcome 2: Service Quality Improvement

• Mobile Outreach Services: Deploy trained nurses to remote villages to deliver vital maternal health services, including ultrasound, anemia screening, and urine protein testing. These outreach services will supplement facility-based care and reach women in their homes.
   
• Cervical Cancer Screening: Implement Visual Inspection with Acetic Acid (VIA) screening programs for women of reproductive age to detect cervical abnormalities early.
   
• Uterine Prolapse Support: Provide screening and culturally appropriate support for the management of uterine prolapse, including integration of traditional healing approaches where appropriate. 

• Strengthening Referral Systems: Partner with referral facilities to reduce barriers in accessing higher-level care for mothers, newborns, children, and adolescents, especially in emergencies or for specialized treatments. 

  Measures related to Outcome 3: Community-Based Health Promotion

• FCHV Support Meetings: Facilitate regular meetings for Female Community Health
   
• Volunteers (FCHVs) to plan activities, share experiences, and strengthen peer support networks.
   
• Mothers' Group Engagement: Organize community Mothers' Group meetings to raise awareness about the importance of maternal and child health services, and how to access them.
   
• Information Dissemination: Distribute health information booklets and introduce a ‘Mother Card’ to help women monitor and manage their reproductive health needs.
   
• Male Engagement: Conduct Male Health Promotion Group meetings to increase men’s understanding of women’s health issues and encourage supportive behaviors within families.
   
• HFOMC Strengthening: Build the capacity of HFOMCs to develop and monitor annual health plans and budgets, ensure full staffing at Health Posts, and maintain regular management oversight.
   
• Municipal-Level Advocacy: Collaborate with Rural Municipalities to advocate for appropriate budget allocation and planning, ensuring the long-term sustainability of services at each Health Post. 

The project is designed with sustainability at its core, aiming to strengthen both the quality of healthcare services and the attitudes of women toward seeking care. All activities are developed in alignment with Government of Nepal (GoN) protocols and standards, ensuring that they are compatible with the existing public health system and resources. 

From the outset, we will work in close collaboration with the Rural Municipality, Ward Offices, and Health Posts to ensure local ownership and facilitate the continuation of activities beyond the project period. Local stakeholders will be actively involved during the planning and implementation phases to promote learning and enable seamless handover of responsibilities. 

The project’s community-level health promotion activities utilize a behavior change communication (BCC) approach, empowering women and girls to adopt healthier behaviors and make informed decisions about their reproductive health. This approach fosters long-term sustainability by promoting community participation, local leadership, and demand for services. 

The implementing partner plays a pivotal role in promoting social sustainability, ensuring that interventions are culturally sensitive and embedded within the community. The improved WASH infrastructure introduced through the project will remain a lasting asset in target villages, contributing to ongoing support for menstrual hygiene and general health. The inclusion of local administrative authorities and the strengthening of community voices in health decision-making will further ensure that women’s health continues to be prioritized. 

The project collaborates with a mother-child health project on the other side of the valley, in the neighboring Rural Municipality of Budhiganga. This project is supported by Karuna Trust UK. This creates synergies that benefit both projects.