Perinatal Death Surveillance and Response: A Secondary Analysis of Nepal’s Efforts

This paper presents Nepal’s experience regarding perinatal death surveillance and the country’s response in reducing preventable perinatal deaths. In developing this paper, evidence of perinatal mortality in Nepal is brought from secondary sources, mainly the assessment report of Maternal and Perinatal Death Surveillance and Response (MPDSR) system. As of 2019, this initiative has been implemented in 77 hospitals across Nepal. Challenges and barriers in implementing the MPDSR system need to be brought to attention, as the system is being scaled up to 110 hospitals. Data from the Perinatal Death Review revealed that 72% of the maternal deaths occurred during the post-partum period, due to (i) post-partum haemorrhage, (ii) hypertensive disorder, (iii) pregnancy-related infections, and (iv) non-obstetric causes. In 70% of the cases such deaths could have been prevented. Majority of perinatal deaths, at 71%, were stillbirths, mainly due to low child weight of less than 2500 grams. In conclusion, there is urgent need for the national guidelines for MPDSR system to be amended, additional and continued training provision to the health workforce, improvement in the coordination and feedback mechanism, and strengthening of the information management system

An Inclusive Schools Principal Perspective Successes and Challenges

The implementation and effectiveness of inclusive education program has been under continuous debate in Pakistan. The present study was conducted in order to understand the perception of a principal with regard to successes and challenges related to Inclusive Education in the context of a private sector school in Karachi, Pakistan. A qualitative case study approach of research was used in order to generate the relevant data. Semi-structured interviews were used to explore principal's perceptions. Other data collection strategies included observations, document analysis, informal discussions and a reflective journal maintained by the researcher. The findings of the study revealed that the principal of the inclusive school considered education as a right of every child, which has lead to inclusion of children with borderline and mild disabilities. The study identified some challenges which the principal is facing in his desire to include all children in his school. These challenges are deeply linked with realities of the world, both inside and outside of school. Lack of awareness, lack of resources and inadequate facilities of professional support are some of the main challenges that hinder effective implementation of inclusive education in Model Inclusive School (pseudonym). The study also reveals some successes which are: supportive leadership, professional attitudes of all staff members, their inclination towards inclusion and the desired academic outcomes of students with special educational needs. Furthermore, the principal's own belief in inclusion and his determination allowed him to ensure inclusion in his mainstream regular school.