Initiated in November 1999, the Maternal and Neonatal Health (MNH/Nepal) Program supports the Government of Nepal's safe motherhood (SM) programme to improve pregnancy outcomes for mothers and their newborns in the country. MNH Partners in Nepal are JHPIEGO - a Johns Hopkins affiliate, the Johns Hopkins University Center for Communication Programs (JHU/CCP), and the Centre for Development and Population Activities (CEDPA). Specific objectives of the MNH/Nepal programme include:

1. Improved policy environment and coordination for safe motherhood;
2. Increased quality of safe motherhood services; and
3. Increased access to and demand for safe motherhood services.

Main Communication Strategies
The SUMATA Initiative is a central component of the MNH/Nepal programme, with its emphasis on participation of key stakeholders. In November 2000, SM partners attended "Speaking with One Voice", a consensus-building workshop that brought together representatives of local, district, and national groups working in SM. A series of smaller workshops were organised to develop a SM advocacy strategy, a SM Information, Education and Communication (IEC) strategy, and SM messages. These activities were designed to enable programme planners to work together to promote birth preparedness and complication readiness by increasing knowledge and by modifying individual, community, and societal behaviours to reduce fatal delays.

Specifically, in Phase 1 areas where Emergency Obstetric Care (EmOC) services are not easily accessible, the messages for change are focussed on gender, women's status, household-level preparedness, and the husband's responsibility. In Phase 2 districts, where EmOC services are available and accessible, messages promote EmOC services and care-seeking behaviours along with the Phase 1 messages. Phase 1 is currently underway at the national level, and Phase 2 work has begun in selected areas where EmOC services are already available and accessible.

Based on the objectives of the IEC Strategy for Safe Motherhood, MNH Program partner JHU/CCP worked with an advertising agency to develop a Nepali-language-based framework for the campaign, whose slogan is "Pregnancy and Childbirth are Special - Make Them Safe". SUMATA encourages husbands and mothers-in-law, in particular, to care for the pregnant woman; to share love and affection, health information, and her workload; and to prepare for childbirth and potential complications. (In Nepali, Care, Share and Prepare is SUMATA, an acronym which also is a word in itself and loosely means Auspicious Mother in Sanskrit).

The SUMATA messages are woven into a multimedia initiative, which includes radio spots and dramas, print materials, community-based street theatre performances, and a television drama. Two national radio spots have been aired on Radio Nepal; seven six-minute SUMATA radio dramas are set to be broadcast. These radio dramas have also been woven into 15-minute radio magazine programmes by the Nepal Safer Motherhood Program and are currently being aired through the Surkhet Regional Radio Station in Nepali as well as in the Tharu language. Similar radio programmes will also be aired through Lumbini FM and Pokhara FM in Nepali as well as in local languages. Also, street theatre troupes have performed 33 dramas in two districts with 100 more dramas to be performed soon in different districts. Both the radio dramas and street dramas are using the same basic scripts, thus reinforcing the same information. A variety of print materials have been developed, including posters, lampshades, danglers, and prayer flags featuring the SUMATA images and messages.

MNH Program partner JHU/CCP recently completed a design workshop to develop a video drama that promotes caring hubands. The script is being written by one of Nepal's dramatic scriptwriters and will be produced by a Nepali production company. The video will be shown on Nepali television, as well as in NGO locales and the popular cinema halls.