Jhpiego presents the International Award for Outstanding Contribution to Midwifery to Nepal’s Maiya Manandhar, a role model for providing services to women. “Maiya’s efforts to save women’s lives are significant. And her work to demonstrate and share her life-saving skills is outstanding,” said one colleague.
As a young girl in Kathmandu, Maiya Manandhar helped care for her mother during the birth of the family’s ninth child. It wasn’t an easy birth, and Maiya’s mother began to bleed heavily once the baby was born. The attention and care the nurses at the local hospital gave her mother impressed young Maiya so much that she decided to follow in their footsteps.
While in nursing school, Maiya discovered her talent and passion for midwifery. The experience of watching her mother endure the pain and difficulty of multiple pregnancies—usually alone—reinforced for Maiya the importance of skilled birth attendants (SBAs), and she pledged to help and support women during childbirth and in caring for their newborns.
She began her career at the Paropakar Maternity and Women’s Hospital, and today, 53-year-old Maiya is the hospital’s nursing supervisor and senior hospital nursing administrator. In this role, Maiya became actively involved in developing a birthing center at the hospital. Run by nurses in a busy maternity ward, this birthing center provides focused, comprehensive care to pregnant women so that when birth-related complications and conditions arise they can be managed more effectively. The birthing center provides care 24/7, 365 days a year, and serves more than 600 to 700 women a month.
With the support of colleagues and doctors, the birthing center has: improved case load management in the labor and delivery room; enabled women to have a spouse or partner present during the birthing process—a departure from routine labor ward practice in Nepal; given pre-service education and in-service training participants more opportunities to participate in normal deliveries; and increased nurses’ involvement in labor and delivery decision-making.
Through her leadership, Maiya is a role model for nurse-midwives, says Dr. Rajendra Bhadra, Jhpiego’s Nepal Country Director, who nominated Maiya for the award. “Having the birthing center run by nurses within the facility provides more concentrated and specialized services for complicated cases. Normal cases are fully managed by nurses.”
Maiya also coordinates the training of SBAs. “There are many remote areas where there is no one to be with pregnant women (like my mother) to support them during delivery,” says Maiya, the mother of two grown daughters. “The SBA I am contributing to and supporting in training might be the one to be with women in remote areas who need SBA support—and she might be saving a mother’s life.”
Maiya says many women arrive at Paropakar Maternity and Women’s Hospital from their villages with complications of obstructed labor or postpartum hemorrhage, and often they are too far along to benefit from any help given at the hospital. She recalls a specific case in which a woman died because her uterus ruptured during obstructed labor.
The pregnant woman had been kept in the local primary care center for more than three days in this life-threatening condition.
“I always thought if a trained SBA was there to access the condition and make a timely referral, this woman’s life could have been saved,” says Maiya.
She has taught her trainees to pay close attention to symptoms that appear to be out of the ordinary or abnormal and to act accordingly because, she says, quick action can save a life.
Honored to receive Jhpiego’s midwifery award, Maiya says she intends to use the prize money to support the recently formed Midwifery Society of Nepal (MIDSON) where she serves as treasurer; help train nurses and midwives working in birth centers in Nepal; pay for complementary feeding for babies of HIV-positive women who do not want to breastfeed; form a support group and provide counseling for mothers who have lost children; and open a daycare center for children of staff working at the hospital.
“Maiya’s efforts to save women’s lives are significant. And her work to demonstrate and share her life-saving skills is outstanding,” says Dr. Bhadra.