Post Natal Home Visit Program

First Visit

This is one of the main activities of Chimalaya Nepal focusing newborn and mother health. According to the government of Nepal post natal check-up are recommended within 24 hours, day 3 and 7 after delivery. However, implementation varies from one community to another and not always feasible to bring at the health center due to condition of mother after delivery. So instead, we are focusing home visits and targeting to meet within one week of delivery so that our health team are familiar with the home condition and support from the family members. In this first home visit, we focus on general examination of newborn (head to toe), length and weight of newborn, screening for general danger sign, breastfeeding assessment (position and attachment) and check- up of mother health condition. During the visit, all these information collect in Tablet and share with the pediatrician at Chimalaya. In case of high risk newborn such as premature, low birth weight, admitted at ICU, problem on feeding or jaundice, we will plan extra visit after few days.

Second Home Visit
At 2 weeks of age, we plan our second home visit and assess general condition of mother and newborn. In this visit, we focus again for the proper attachment and position of breastfeeding and remind importance of exclusively breastfeeding for first 6 months of life. We also examine adequacy of breastfeeding by taking length and weight and also asking frequency of breastfeeding and urine and stool pass in last 24 hours period. If exclusively breastfeeding is not possible for one reason or another, alternative options are discussed to ensure the child’s nutritional needs are secured. We also guide the parents in general signs of well-being in the newborn, as well as signs of illness and unwellness and when they should contact Chimalaya or the doctor.

Third Home Visit
When the newborn is one month of age, we schedule our 3rd visit. The objective of 3rd home visit is also to ensure proper exclusive breastfeeding and any health concerns and complaints. We also provide advice and guidance on how parents can support the child’s motor, language and emotional development In this visit, we will also discuss plan of mother to resume back work if she is working mother. For working mother, is they need to leave baby at home, we will discuss how they can express breast milk and store at room or freezer. If manual expressing of breastmilk is not possible, alternatives to mother’s milk are discussed, to ensure that the child’s nutritional needs are met, depending on the child’s age. During the home visit, our team is also screening mother for any signs related with post natal depression and communicate with doctors if there any concern and suspicion.

Fourth home visit
At six months of age, we have last home visit and assess growth (by taking length and weight) and also interact with baby to assess cognitive development. Our health team is trained to assess infant for the general activity level, eye contact, facial expression, vocalization and relationship to observer to find out any signs of social withdrawal as per the Alarm Distress Baby Scale (ADBB) scoring. Based on what we assess in this ADBB screening, the parents are guided in how they can play and connect with their baby, to support the child’s social attachment, as well as the emotional and language development.

Bag4life

During home visit, we distribute a bag to the mothers as a token of love. We call it ‘Bag4Life’ which contain children clothing, sanitary products, thermometer and more. We believe the ‘Bag4Life’ is very useful asset for mother and family and all the medical records (birth certificate, vaccine and hospital visit) can safely keep inside the bag.