Nepal’s Safe Motherhood Program has increased hospital births to 80% and reduced maternal mortality by 72%. Nurses bring critical care to remote areas, ensuring safe deliveries. But sustaining progress requires innovation as donor support wanes.
Also in today’s edition: We tell you all about MOPAN, provide tips on clinching a project management job, and highlight the push for digitalized health.
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In the rugged terrains of Nepal’s Karnali province, a heartwarming scene unfolds as nurse Samjhana Salami operates a portable ultrasound on a pregnant woman, revealing the flicker of a new heartbeat. Despite the quick pace due to a long queue outside the clinic, there’s a sense of triumph. Not long ago, many women in this remote area would have opted for home births due to the difficult trek required to access medical care, risking serious complications.
The landscape has drastically changed thanks to Nepal’s robust efforts under the National Safe Motherhood Program, initiated in 2005 with incentives like travel reimbursements and free hospital births. Antenatal checkups have become the norm, not the exception. “Even four or five years back, there were lots of home deliveries happening in this part, but in the last year there were zero home deliveries,” Salami remarks proudly.
The program’s impact is profound, with hospital births soaring from 10% to almost 80% and maternal mortality plummeting by 72% since 1996. It’s a stellar example of how targeted government actions and international support can turn the tide on public health crises. Yet, the journey is far from over, writes Catherine Davison for Devex.
With donor interest waning and the government’s health budget stretched thin, Nepal faces new challenges in maintaining these gains and pushing toward the United Nations’ goal of an even lower maternal mortality ratio by 2030.
As international partners recede, the urgency to build self-sustaining improvements in health care quality and access is palpable. In remote villages, trained nurses like Salami trek monthly into the mountains, ensuring that every pregnant woman has a fighting chance for a safe delivery. The stakes are high, and the resources are finite, but the resolve to keep mothers and their babies safe remains unshaken, fueled by success stories and the critical need for continued support and innovation in maternal health care.
Explore the visual story: The push to reduce maternal mortality in the remote regions of Nepal
Given its detailed work and the state of global cooperation these days, the Multilateral Organisation Performance Assessment Network, aka MOPAN, should arguably be better known.
Hosted by the Organisation for Economic Co-operation and Development in Paris since 2013, the network began in 2002 and now counts 22 donor members, who together provide $100 billion in annual contributions to and through the multilateral system. MOPAN studies different bodies — from development banks to U.N. agencies — in an effort to improve the multilateral system.
Two new assessments dropped in the run-up to Christmas, on UN-Habitat and the Global Partnership for Education, or GPE — and it's not all rosy, my colleague Vince Chadwick tells me.
UN-Habitat was lauded for taking a more “realistic, managed and transparent” approach to its “consistently low” funding levels. Yet, the assessment warned, “Training and professional development are lagging, resulting in skill gaps that undermine the organisation’s effectiveness.”
Not to mention, the agency's “[struggle] to implement a coherent system that links activities with strategic objectives, impacting its ability to accurately track and report performance.”
GPE was advised to “better demonstrate results with relevant and timely data.”
Its value and strength is the way it unites education groups around the world, the assessment found. However, as a funding agency, the report argued that GPE’s “strategic positioning and value-added in a dynamic global context are less clear from the perspectives of some of its constituency groups, creating perception of duplications with other organisations.”
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In the past, community health workers in low- and middle-income countries relied on paper notebooks to gather and report data, such as tracking childhood immunizations. Today, while there’s a big push to digitize health care, it’s also created new headaches: countless apps and systems from different organizations that have often made the process confusing and burdensome.
At the Global Digital Health Forum in Nairobi, experts called for integrating and streamlining digital health systems, using common standards to fix the messy data landscape. Matt Berg, CEO of Kenyan-based Ona, notes, “We haven't really achieved its full potential — a lot of this is because of the fragmentation of services.”
One promising solution is FHIR — Fast Healthcare Interoperability Resources, a global standard for exchanging health information electronically. Think of it as a “universal language” for health systems, enabling smooth data sharing. Jean-Philbert Nsengimana from the Africa Centres for Disease Control and Prevention quips, “We are going to put Africa on FHIR,” to address disjointed systems.
The World Health Organization’s SMART guidelines leverage FHIR to turn health recommendations into machine-readable formats, reducing errors and simplifying updates. For instance, a developer without medical experience can now create reliable health apps using WHO’s standardized guidance.
But it's not just a flip of a switch — work must be done to get everybody using the same standards. Moving toward FHIR and SMART guidelines adoption can involve high upfront costs in areas such as infrastructure and moving existing data in this direction. Governments and development partners can have a significant influence in pushing this forward.
Read more: The push to standardize digital health
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Tools, teamwork, and adaptability lead the way. Project management is one of the most in-demand roles in global development, offering dynamic, high-responsibility opportunities to deliver international aid, humanitarian projects, and more. In the past year alone, 256 project manager positions were listed on the Devex job board, with salaries ranging from $53,000 to $58,000.
Pau Jiménez Inglès, a Catalonia-based project manager at ClientEarth, and Santosh Pandey, who is based in Nepal and was formerly a country humanitarian focal and project manager at Mercy Corps, tell Devex’s Katrina Lane what it takes to break into this field and thrive:
Master the tools: Certifications like Prince2, PMP, and Scrum Agile aren’t just résumé boosters — they’re essential. “The more different methods you know, the more flexible you will be able to be in your approach to managing projects,” Jiménez says. Start with frameworks like Prince2 for managing budgets and risks, and keep learning. Jiménez still refers to his old Prince2 book for guidance.
Mitigate risks like a pro: In crisis-prone environments, risk management is key. Identify risks early and document them in risk logs. Sharing these insights with your team ensures you don’t miss anything critical.
Adapt and solve problems: Working in conflict zones or disaster-struck areas means expecting the unexpected. Jiménez advises pausing to weigh the pros and cons before taking action and seeking outside perspectives to resolve tough situations.
Be a team player: Empathy and communication are essential. Pandey highlights the importance of collaboration, from local governments to NGOs, while Jiménez reminds us that a respectful, open attitude helps unite diverse stakeholders.
Start small, think big: Entry-level roles like project assistants can open doors to project management. Employers value mindset and adaptability as much as technical skills. Stay curious, keep learning, and build your way up.
Read: How to succeed as a project manager in global development (Career)
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Japan announced new sanctions against Russia over its war on Ukraine, including freezing the assets of numerous individuals and groups while banning exports to Russian organizations. [AP]
The U.N. welcomed the election of General Joseph Aoun as Lebanon's president, with Secretary-General António Guterres hailing it as a vital step toward resolving the country's two-year political impasse. [UN News]
The European Union’s climate monitor has confirmed 2024 as the hottest year on record, with global temperatures exceeding the critical 1.5 degrees Celsius threshold. [Al Jazeera]
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